For Providers
Exciting Updates for 2026: Managed Care Expands Statewide
Nevada’s Medicaid system is undergoing a major transformation to improve access and simplify care delivery. The newly formed Nevada Health Authority now oversees Medicaid, the Nevada Health Insurance Exchange, and other key health services—bringing them under one coordinated structure.
Beginning January 1, 2026, Managed Care will expand into rural Nevada, transitioning approximately 75,000 residents from Fee-for-Service (FFS) Medicaid into Managed Care. SilverSummit Healthplan has been selected as one of the Managed Care Organizations (MCO) to provide services to ALL Nevada counties. In addition, Health Plan of Nevada (HPN) members are being reassigned in Washoe County to four MCOs, and Clark County members are being redistributed to accommodate the entry of a new MCO.
Login
If you are a contracted SilverSummit Healthplan provider, you can access the portal by clicking on the login button below. You will be able to provide your login credentials or register for an account.
Once you have created an account, you can use the SilverSummit Healthplan provider portal to:
- Verify member eligibility
- Manage claims
- Manage authorizations
- View patient list
What's Changing
Rural Expansion
Starting January 1, 2026, MCO managed care coverage will be available in all rural Nevada counties for the first time. Members currently under Fee-for- Service (FFS) will be distributed between SilverSummit Healthplan and the other MCO, ensuring comprehensive managed care access across rural counties.
October 2025: First Formal Notification to Redistribution Population that changes are coming to Nevada Medicaid
October 2025: Open Enrollment starts for Non-Redistributed Population
December 2025: Mid-December: Notification letter sent to Redistributed Population (HPN), a new MCO assignment
January 1, 2026: New Members Effective Date
January 1–March 31: 2026: Switch-Back Period and Choice Period (Redistributed Population)
As a trusted provider, you can help rural patients navigate their move from Fee-for-Service (FFS) Medicaid to Managed Care:
- Reassure Patients: Their Medicaid benefits remain the same. SilverSummit will now coordinate their care and offer new, no-cost services like housing support.
- Ensure Continuity: Let patients know their care and appointments will continue without disruption.
- Share Resources: SilverSummit teams will be in the community to support members.
Member Services: 1-844-366-2880 TTY: 1-844-804-6086
- Explain the Choice Period: Patients may change their Managed Care Organization between Jan 1 – Mar 31, 2026.
Washoe County Update
Beginning January 1, 2026, HPN will no longer offer Managed Care services in Washoe County. Medicaid members currently enrolled with HPN will be transitioned into one of four MCOS, SilverSummit, Anthem, Molina and CareSource. This process, known as Redistribution, ensures a smooth transition for affected members.
October 2025: First Formal Notification to Redistribution Population that changes are coming to Nevada Medicaid
October 2025: Open Enrollment starts for Non-Redistributed Population
December 2025: Mid-December: Notification letter sent to Redistributed Population (HPN), a new MCO assignment
January 1, 2026: New Members Effective Date
January 1–March 31: 2026: Switch-Back Period and Choice Period (Redistributed Population)
If patients have questions or concerns, please reassure them of the following:
- No change to medical coverage: Their Medicaid benefits will remain the same.
- Continuity of Care: Patients can keep their current doctor and continue receiving care without interruption.
- Open Enrollment: Remind your patients to update their information to ensure they receive their renewal packet. The Open Enrollment process remains the same as in previous years.
Clark County Update
Beginning new MCO will join the existing four MCOs in providing services in Clark County. As part of this change, some Medicaid members will transition to the new plan.
October 2025: First Formal Notification to Redistribution Population that changes are coming to Nevada Medicaid
October 2025: Open Enrollment starts for Non-Redistributed Population
December 2025: Mid-December: Notification letter sent to Redistributed Population (All MCOs) of new MCO assignment (CareSource)
January 1, 2026: New Members Effective Date
January 1–March 31: 2026: Switch-Back Period and Choice Period (Redistributed Population)
If patients have questions or concerns, please reassure them of the following:
- No change to medical coverage: Their Medicaid benefits will remain the same.
- Continuity of Care: Patients can keep their current doctor and continue receiving care without interruption.
- Open Enrollment: Remind your patients to update their information to ensure they receive their renewal packet. The Open Enrollment process remains the same as in previous years.
Transportation Expanded to Rural Nevada
SilverSummit Healthplan offers a Medical Ride Program to ensure eligible Members can access non-emergency medical transportation (NEMT) at no cost. This service helps remove transportation barriers, ensuring patients can attend their medical appointments reliably.
Key Program Details for Providers:
- The program covers transportation to and from non-emergency medical appointments.
- Ambulance trips are not included in this program.
- Transportation is provided curb-to-curb for members.
Please share the following options with your SilverSummit patients to help them arrange their rides:
- Call for a SafeRide - Members can call 1-844-366-2880 at least 24 hours before Member’s scheduled ride
- Use the SafeRide Member Portal - Members can access the SafeRide Member Portal to schedule rides online.
- Educate patients about the availability of the Medical Ride Program and how to schedule transportation.
- Verify eligibility for the program through SilverSummit Healthplan if needed.
For additional information about the Medical Ride Program or to assist your patients, contact SilverSummit Healthplan.
