Wellpoint Medicaid Managed Care Plan Transition Effective August 1

July 21, 2026

Wellpoint Medicaid Managed Care Plan Transition Effective August 1

Effective August 1, 2026, enrollees in the District of Columbia Medicaid Managed Care Program who are currently enrolled with Wellpoint DC (formerly Amerigroup DC) will be automatically assigned to AmeriHealth Caritas DC (AmeriHealth).

Wellpoint is responsible for reimbursement of all covered services rendered to its enrollees through July 31, 2026, at 11:59 p.m. This also includes medical/surgical inpatient admissions extending beyond the termination date.

During the transition period:

Prior Authorizations (PAs): Providers shall consider all active referrals or authorizations issued before August 1, 2026, valid and effective through October 31, 2026, whether or not the provider is contracted with AmeriHealth or MedStar. AmeriHealth and MedStar agree to honor active referrals and PAs previously issued before August 1, 2026.

Specialist Referrals: Specialty providers are expected and authorized to initiate their own referrals for additional tests and procedures. The Specialist should not refer the patient/enrollee back to their primary care physician (PCP) to obtain a referral for such services. The additional services are covered under the initial referral to the specialty provider. Health care providers are not to cancel appointments with current patients. AmeriHealth must honor any ongoing treatment that was authorized prior to enrollment into the health plan, for up to 60 days or the last day of the transition period.

Pharmacy: All active prescriptions will be honored during the transition period. AmeriHealth must allow enrollees to continue to receive prescriptions through their current provider through October 31, 2026, or until their prescriptions can be transferred to a provider in the health plan’s network.

Enrollees have until January 31, 2027, to select MedStar Family Choice DC (MedStar) if they don’t want to stay with Amerihealth.

Patients may contact Laura Williams at mpswebinquiries@wellpoint.com or 800-454-3730, for assistance after the termination date of the contact. Community of Hope will also assist with your concerns. Please call 202.540.9857 for assistance.