Member Information

As a member of Jai Medical Systems, you are eligible to receive many benefits and services. A summary of our benefits and services is presented below.

As a member of Jai Medical Systems, you are eligible to receive many benefits and services. A summary of our benefits and services is presented below.

Overview of Benefits & Services

Jai Medical Systems Managed Care Organization, Inc. is a Medicaid Managed Care Organization providing Medicaid health insurance benefits for the State of Maryland in the HealthChoice program.

Some of our benefits and services for both children and adults include:

  • Your own Primary Care Provider
  • Dental care
  • Specialty care services
  • Inpatient and outpatient hospital services
  • Emergency services
  • Health screenings
  • Well child care and immunizations
  • Lead paint poisoning treatment
  • Substance abuse treatment services
  • 24-hour doctor hotline
  • Mental health services
  • HIV/AIDS treatment
  • Family planning and OB/GYN services
  • Radiology and lab services
  • Diabetes care
  • Pharmacy services
  • Eye exams and glasses
  • Case Management services

All members can benefit from our extensive network of pharmacies, which includes:

  • Rite Aid
  • Giant
  • CVS
  • The Epic Network
  • Govans
  • Safeway
  • Target
  • Weis

For more information regarding our preferred drug list, drug information, and drug list management procedures, please follow the links below:

Preferred Drug List
Drug-to-Drug Interaction
Drug List Management Procedures
Prior Authorization Guidelines

Members who need to request an exception for a medication that is not covered on the formulary may also download the form below for their provider to fill out and submit.

Prescription Prior Authorization Form

 Additional Benefits Offered by Jai Medical Systems includes:

  • Adult Dental Services
    • Oral Exam and Cleaning every six months
    • X-Rays, fillings, and simple extractions
      (The annual benefit limit for all covered dental services is up to $500 per calendar year.)
  • Free Transportation to your Primary Care doctor visits
  • Health Education
  • No Prescription Co-Pay

Special Announcements

Important Notice to Members

Utilization management decisions made by Jai Medical Systems Managed Care Organization, Inc. staff are based on the appropriateness of care and the availability of benefit coverage. There are no financial incentives or rewards provided to Jai Medical Systems Managed Care Organization, Inc. staff for utilization management decisions, including for denials of coverage or underutilization of coverage benefits.

For a comprehensive list of benefits and services offered by Jai Medical Systems, please refer to your Member Handbook.  Our Member Handbook is available online on our Member Portal. If you would like to request a copy of the Member Handbook, please contact our Customer Service Department today at 1-888-JAI-1999.

New Member Notice – Continuity of Health Care

If you are a new member, and may be moving from another managed care organization (“MCO”) or another company’s health benefit plan to Jai Medical Systems Managed Care Organization’s coverage, please read this notice regarding the Continuity of Health Care. If you have any questions, please feel free to contact our Customer Service Department at 1-888-JAI-1999.