Haris Ashley
MMC is used to refer to the health insurance plans of two institutions: Marymount Manhattan College and Meharry Medical College. Marymount Manhattan College requires all students enrolled in 12 or more credits to have comprehensive health insurance that will cover them for sickness or injury while attending school in NYC. Meharry Medical College, on the other hand, requires that all registered students have health insurance or purchase the college-sponsored group plan. Additionally, MMC is also used to refer to Medicaid Managed Care, a general term used to describe any health insurance plan or system that coordinates care through a primary care practitioner.
| Characteristics | Values |
|---|---|
| Description | Medicaid Managed Care (MMC) is a health insurance plan that coordinates care through a primary care practitioner, controlling quality, cost and utilization. |
| Enrollment | Most Medicaid-eligible individuals are required to enroll in an MMC Plan. |
| Exemptions | Consumers are not required to join an MMC Plan if they are exempt or excluded. Exemptions are outlined in NYS Social Services Law section 364–j(3)(d). |
| Benefits | MMC Plans provide enrollees with access to a comprehensive range of preventative, primary, specialty, ancillary and inpatient services through their provider networks. |
| Cost | MMC is paid a capitated rate (per member/month) by NYS. |
| Providers | MMC has partnered with University Health Plans to administer the plan. |
| Contact | University Health Plans can be reached at 833-251-1711 or [email protected]. |
| Opt-out | Students with comprehensive health insurance can opt-out of the MMC SHIP by completing the waiver form. |
| Student Requirements | All students enrolled in 12 or more credits at Marymount Manhattan College (MMC) are required to have comprehensive health insurance. |
| Student Plan Provider | UnitedHealthcare Student Resources. |
| Student Plan Cost | $2,874 for the annual period (8/15/24 – 8/14/25). |
| Student Plan Benefits | Modest deductible and co-insurance, as well as a robust nationwide network of providers. |
| Student Visa Requirements | International students at MMC on an F-1 Visa residing in the US are required to maintain the MMC SHIP. |
| Student Insurance Team Contact | [email protected] |
| Student Insurance Provider | Aetna |
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What You'll Learn
MMC and Medicaid Managed Care
Medicaid Managed Care (MMC) is a health insurance plan or system that coordinates care through a primary care practitioner. It is designed to control quality, cost and utilization, focusing on preventive care. MMC provides Medicaid state plan benefits to enrollees through a managed care delivery system comprised of Managed Care Organizations (MCOs).
Most Medicaid-eligible individuals are required to enroll in an MMC plan unless they are exempt or excluded. To be eligible for Medicaid, an individual must meet the criteria in Section 364-j of the SSL and/or New York State's Operational Protocol for the Partnership Plan. MMC plans are responsible for ensuring enrollees have access to a comprehensive range of preventative, primary, specialty, ancillary and inpatient services through their provider networks.
As of July 2024, 42 states (including Washington DC) contract with comprehensive, risk-based managed care plans to provide care to at least some of their Medicaid beneficiaries. Oklahoma is the latest state to implement capitated, comprehensive Medicaid managed care, which it did on April 1, 2024.
In FY 2023, state and federal spending on Medicaid services totalled over $880 billion. Payments made to MCOs accounted for about 52% of total Medicaid spending. The share of Medicaid spending on MCOs varies by state, but over three-quarters of MCO states directed at least 40% of total Medicaid spending to payments to MCOs.
While the shift to MCOs has increased budget predictability for states, the evidence about the impact of managed care on access to care and costs is both limited and mixed.
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MMC Student Health Insurance Plan
Marymount Manhattan College (MMC) requires all students enrolled in 12 or more credits to have comprehensive health insurance that will cover them for sickness or injury while attending school in NYC. The college offers a Student Health Insurance Plan (SHIP) provided by UnitedHealthcare Student Resources. The plan includes a deductible and co-insurance, as well as a nationwide network of providers. The cost for the 2024-2025 academic year is approximately $2,874, and students are automatically billed for it. However, students can choose to waive the SHIP if they have alternative comprehensive health insurance. To do so, they must complete a waiver form and compare the cost, coverage, and benefits of the SHIP to their existing plan.
Meharry Medical College (MMC) also offers a student health insurance plan, with medical, vision, and dental coverage. This plan is administered by Aetna Student Resources, and students can access their insurance benefits and cards online. International students attending Meharry Medical College on an F-1 Visa and residing in the United States are required to enrol in the college's insurance plan. Students who waived the SHIP at Marymount Manhattan College may qualify for special enrollment rights if they lose their previous coverage.
The MMC Student Health Insurance Plan at both colleges provides students with access to a range of healthcare services, ensuring they can maintain their health and well-being during their studies. Students can refer to the specific websites and contact information provided by their respective colleges for detailed information on their insurance plans, requirements, and procedures.
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MMC and Managed Care Organizations
Medicaid Managed Care (MMC) is a type of health insurance plan that provides Medicaid state plan benefits to enrollees through a managed care delivery system. This system is comprised of Managed Care Organizations (MCOs) that coordinate care through a primary care practitioner, controlling quality, cost, and utilization, with a focus on preventive care.
Nearly all states in the US have some form of managed care in place, with 42 states (including Washington DC) contracting with comprehensive, risk-based managed care plans as of July 2024. States have increased their reliance on managed care delivery systems to improve access to services, enhance care coordination and management, and make future costs more predictable. Medicaid Managed Care is the dominant delivery system for Medicaid enrollees, with 75% of beneficiaries enrolled in comprehensive MCOs as of 2022.
MCOs provide comprehensive acute care, including most physician and hospital services, and in some cases, long-term care. They are paid a set rate per member per month for these services, which has improved budget predictability for states. However, the impact of MCOs on access to care and costs is mixed, and there are variations across states. While MCOs accounted for about 52% of total Medicaid spending in FY 2023, the share of spending on them varies, with certain states directing over 40% of total Medicaid dollars towards MCO payments.
In addition to state-level variation, MCOs also differ in their prior authorization denial rates, with Medicaid MCOs having a higher denial rate than Medicare Advantage. This has raised concerns about access to care for Medicaid enrollees, and recommendations include strengthening state monitoring of denials and improving the appeals process.
MMC is also associated with student health insurance plans at institutions like Marymount Manhattan College and Meharry Medical College. These plans are typically ACA-compliant, offering access to a national network of providers, and may be required for international students on specific visas. Students can opt-out of these plans if they have comprehensive coverage under another plan.
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MMC and Medicaid eligibility
Medicaid Managed Care (MMC) is a health insurance plan that provides Medicaid state plan benefits to enrollees through a managed care delivery system. This system is made up of Managed Care Organizations (MCOs) that provide care to Medicaid beneficiaries.
Most Medicaid-eligible individuals are required to enrol in an MMC plan unless they are exempt or excluded. Exemptions are outlined in NYS Social Services Law Section 364-j(3)(d). However, under the Medicaid Redesign Team initiatives, most exemptions and exclusions are removed, and consumers are required to enrol in MMC to obtain Medicaid-covered services.
MMC plans are responsible for ensuring that enrollees have access to a comprehensive range of preventative, primary, specialty, ancillary, and inpatient services through their provider networks. This includes coordinating care through a primary care practitioner and controlling quality, cost, and utilization, with a focus on preventive care.
While managed care is the dominant delivery system for people enrolled in Medicaid, there is variation across states in terms of which populations and services are included in managed care arrangements. States have flexibility in certain areas, such as setting provider payment rates, and may offer additional benefits beyond those required.
As of July 2024, 42 states, including Washington DC, contract with comprehensive, risk-based managed care plans to provide care to at least some of their Medicaid beneficiaries. Medicaid MCOs provide acute care and, in some cases, long-term care to Medicaid beneficiaries and are paid a set rate per member per month for these services.
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MMC and health insurance waivers
MMC can refer to Marymount Manhattan College or Medicaid Managed Care.
Marymount Manhattan College (MMC) and Health Insurance Waivers
Marymount Manhattan College (MMC) requires students enrolled in 12 or more credits to have comprehensive health insurance that will cover them for sickness or injury while attending school in NYC. All students enrolled in 12 or more credits are automatically billed for the Student Health Insurance Plan (SHIP). International students attending MMC on an F-1 Visa who are residing in the United States are required to maintain the MMC SHIP.
Students who already have comprehensive health insurance can opt-out of the MMC SHIP by completing the waiver form. It is important to compare the cost, coverage, and benefits of the SHIP to your existing plan before waiving. Out-of-state Medicaid and many HMO or EPO plans do not provide out-of-network coverage. Students who waived the SHIP may qualify for special enrollment rights if they lose coverage under their prior plan.
Medicaid Managed Care (MMC) and Health Insurance Waivers
Medicaid Managed Care (MMC) is a health insurance plan that coordinates care through a primary care practitioner and controls quality, cost, and utilization, focusing on preventive care. Nearly all states have some form of managed care in place, and most Medicaid-eligible individuals are required to enroll in an MMC Plan unless exempt or excluded.
While managed care is the dominant delivery system for Medicaid, states decide which populations and services to include, leading to variations across states. States have flexibility in certain areas, such as setting provider payment rates, and plans may offer additional benefits beyond state requirements. However, evidence of the impact of managed care on access to care and costs is limited and mixed.
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Frequently asked questions
MMC medical insurance refers to the student health insurance plan offered by Marymount Manhattan College (MMC).
All students enrolled in 12 or more credits are automatically billed for the MMC student health insurance plan. International students at MMC on an F-1 Visa who are residing in the United States are also required to enroll in this insurance plan.
The cost of the MMC student health insurance plan is approximately $2,874 for the annual period (8/15/24 – 8/14/25).
To enroll in the MMC student health insurance plan, visit universityhealthplans.com/mmc and complete the enrollment form.
Yes, you can waive the MMC student health insurance plan if you already have comprehensive health insurance. To do so, you need to complete the waiver form on the University Health Plans website: universityhealthplans.com/mmc.
