Organizations that provide a comprehensive range of basic and supplemental health care services for a voluntarily enrolled population on a prepaid and fixed periodic basis. Members are generally required to use health care professionals who are part of the HMO's network of providers. Also included are medical groups which provide health care for HMO members on a contract with the HMO.

State programs (or private vendors under contract with the state) that enroll Medicaid recipients in a Medicaid managed care program that coordinates the provision, quality and cost of care for its enrolled members. Recipients may have a designated amount of time to choose a managed care option following eligibility determination; and once enrolled, select a primary care practitioner from the plan's network of professionals and hospitals who will be responsible for coordinating their health care and referring them to specialists or other health care providers as necessary. In some situations, where acute and primary care are not integrated into the selected option, people may work with a multidisciplinary team of professionals to support service plan development and implementation. Enrollment in a managed care plan may be voluntary or mandatory for some or all Medicaid recipients in a state. Participation requirements and associated criteria vary from state to state and in some cases, from area to area within the same state. States often make exceptions to their mandatory enrollment requirements for certain individuals and groups, e.g., people with disabilities or identified health conditions, who may be served outside the state's managed care delivery system. These individuals may enroll in a managed care program but are not required to do so. States may also identify a range of Medicaid eligibility groups who are excluded from participating in their managed care programs. Also included are other programs that help people prepare and file State Medicaid Managed Care enrollment applications.

Private insurance companies that issue managed care policies to people who qualify under Medicaid, generally on the basis of a contractual arrangement with the state. Enrollment in a managed care plan may be voluntary or mandatory for some or all Medicaid recipients in a state; and participation requirements and associated criteria vary from state to state and in some cases, from area to area within the same state. Benefits covered by Medicaid vary by jurisdiction but generally include hospitalization, physician services, emergency room visits, family planning, immunizations, laboratory and x-ray services, outpatient surgery, chiropractic care, prescriptions, eye exams, eye glasses and dental care. Other covered services may include alcohol and drug treatment, mental health services, medical equipment and supplies and rehabilitative therapy. Medical benefits are administered by the insurance companies under terms of their contract.

Individuals who are generally between the ages of 18 and 25 depending on the ages that specific programs use for qualification.

Low-income individuals who are receiving comprehensive medical benefits through the federal Medicaid program administered by the county or the state.

Women who are awaiting the birth of a child.