Important Notice for HPN’s Medicaid Providers - Updated 10/23/2025
Below is a summary of updates for Health Plan of Nevada Medicaid. Additional details will be provided as they become available. Information provided in this notification is subject to change.
Health Plan of Nevada Medicaid Service Area Reduction
Effective January 1, 2026, HPN’s Medicaid service area will be Urban Clark County only. We are working with Nevada Medicaid to help implement the successful transition of our Washoe County and Rural Clark County members to another MCO.
Plan Name Update
We updated our Medicaid plan name to Health Plan of Nevada Medicaid to more closely align with our local HPN products and services. There are no changes to how our providers work with us.
Changes Coming to Medicaid Plans Impacting Approximately 45,000 HPN Medicaid Members
Nevada Medicaid Implementing Redistribution of Medicaid Membership
Nevada Medicaid will implement the redistribution of Medicaid enrollees who reside in Urban Clark County, Rural Clark County and Washoe County for the mandatory managed care delivery program effective January 1, 2026.
- Beginning January 1, 2026, Nevada’s Medicaid program will have five MCOs: Health Plan of Nevada, Anthem, SilverSummit, Molina and CareSource. Nevada Medicaid will redistribute a percentage of membership to CareSource for an effective date of January 1, 2026.
- In October, Nevada Medicaid will mail impacted members a pre-distribution letter notifying them that they will be moved to CareSource effective January 1, 2026.
- Redistributed members in Urban Clark County will have the opportunity to switch back or change to HPN during the 90-day choice period from January 1 to March 31. Please click here for member benefits to switch back to HPN.
- There are some parameters set by Nevada Medicaid regarding which members are eligible for redistribution based on active treatment or health condition, such as pregnancy. HPN will work with our providers to identify these members.
- Click here for more information.
Nevada Medicaid’s Open Enrollment Period Has Changed
This year’s open enrollment period for Medicaid members in Nevada is October 1 through December 26.
- Open enrollment letters will be mailed by Nevada Medicaid to non-redistributed members in October.
- Members in Urban Clark County who switch to a different plan during open enrollment can switch to HPN during the 90-day choice period from January 1 to March 31. Please click here for member benefits to switching to HPN.
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