The SSI Managed Care External Advocacy Project (SSI-MC EAP) serves people enrolled in SSI-related Medicaid and HMOs (Health Maintenance Organizations) in Wisconsin. HMOs are private insurance companies that provide managed health care to their members. Managed care is a way of controlling costs while providing quality health care. All the services covered by Medicaid are covered by HMOs.
The Department of Health Services (DHS) contracts with Disability Rights Wisconsin (DRW) to provide advocacy to those enrolled in an SSI Managed Care organization.
How We Help
SSI-MC EAP provides information for people who have questions about the SSI Managed Care Program and provides advocacy services to people enrolled in SSI HMOs.
What the SSI-MC External Advocate can do for you:
- Help you understand the enrollment process.
- Explain your rights and responsibilities as a member of a HMO.
- Make sure you continue to get the care you need from your same health care providers for the first three months (at least) of enrollment in the HMO.
- Help you get answers to questions about your HMO and health care.
- Help you get the specialty care or medical equipment you need.
- Help you get transportation for Medicaid covered services.
- Help you with medical billing problems.
- Help you get mental health or AODA treatment if you need it.
- If your care is ever delayed, denied, limited or ended, help you understand why.
- Help you appeal decisions by your HMO.
To get SSI-MC External Advocacy Project helpfrom Disability Rights Wisconsin, you must be:
- Age 19 and older,
- Have any type of disability, and
- Be enrolled in or have received enrollment information about the Wisconsin Medicaid SSI HMO Program.
(Note: People in managed care in BadgerCare Plus and Medicaid Long Term Care Waivers such as Family Care and IRIS, and Medicaid recipients not in managed care are not included in this project.)
Our SSI-MC team is made up of highly knowledgeable advocates with a long history of navigating through the SSI Managed Care Program. If you want to read more about our team members please go to our team directory.