Medallion 4.0

Overview

The Medallion 4.0 is a statewide Medicaid program. The Medallion 4.0 program provides services to qualified members in the areas of maternity care, including early prenatal care, case management, and postpartum care; care for infants and children, including early intervention services, immunizations, screening, and preventive care; and wellness, behavioral health, community mental health services, behavioral therapy, family planning and chronic disease support for adults.

Who Participates in Medallion 4.0?

Medallion 4.0 includes Medicaid members who are eligible in the following Medicaid coverage groups: 

• Pregnant women
• Pregnant women who qualify for health care coverage under the FAMIS MOMS program if their family does not exceed income limits
• Infants, children and youth
• Children and Youth with Special Health Care Needs
• Individuals included in Medicaid expansion who were already enrolled in a limited benefit program such as Plan First
• Medicaid expansion adults ages 19-64 who are not eligible for Medicare. (Parents or caretaker adult relatives living with a child under age 19 may be eligible for full coverage Medicaid if family income does not exceed the limit.)
• Foster Care & Adoption Assistance. Former Foster Care youth who are between ages 18- 26 and were in foster care and receiving Medicaid in any state at the time of their 18th birthday.

Medallion 4.0 Members

Please visit the Medallion 4.0 enrollment website to view the health plan comparison chart and choose a health plan. Members can also call the Managed Care HelpLine at 1-800-643-2273, TTY 1-800-817-6608, Monday – Friday, 8:30 a.m. to 6:00 p.m.