> ## Documentation Index
> Fetch the complete documentation index at: https://mso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Centene

> Centene profile: the Medicaid managed care specialist, Ambetter and state-specific brands, and why you enroll with the state plan.

**Centene** is the largest Medicaid managed care organization in the US, operating through **state-specific brands** rather than a single national name. Its marketplace products carry the **Ambetter** brand. For a practice, the operational fact is that you contract with the **state plan**, not the parent.

**Payer content ages fastest of anything on this site.** Portals move, forms change, payer IDs get reassigned, and **timely filing limits are contract-specific regardless of what any table says**. Treat this page as orientation; the payer's own current documentation and **your executed contract** are authoritative. **Checked August 2026.**

## Who they are

|                       |                                                                                                               |
| --------------------- | ------------------------------------------------------------------------------------------------------------- |
| **Parent**            | Centene Corporation                                                                                           |
| **Core business**     | **Medicaid managed care**, across many states                                                                 |
| **Marketplace brand** | **Ambetter**                                                                                                  |
| **Other lines**       | Medicare Advantage (including Wellcare), TRICARE administration in some regions, behavioral health (Magellan) |

**Enroll with the state plan.** Centene operates under different brand names in different states — Peach State Health Plan, Sunshine Health, Superior HealthPlan, Buckeye Health Plan, and many others. Your contract is with the state entity, and a contract in one state does not extend to another.

## The two-layer Medicaid problem

Contracting with Centene's state Medicaid plan is **in addition to** enrolling with the state Medicaid agency, not instead of it.

<Steps>
  <Step title="Enroll with the state Medicaid agency">
    Required to serve Medicaid beneficiaries at all.
  </Step>

  <Step title="Contract and credential with each MCO">
    Including Centene's state plan, and every other MCO in your service area.
  </Step>
</Steps>

See [Enroll in state Medicaid](/guides/enrollment/enroll-in-medicaid).

## Enrollment and credentialing

Through the state plan's provider site. Many states use a **single credentialing verification organization** for all Medicaid MCOs — check whether yours does, because it materially reduces the work.

## EDI, ERA, and EFT

Per state plan. Payer IDs differ per state brand.

## Appeals

Plan appeal, then the **state fair hearing** process. Medicaid appeal rights differ from commercial and are governed by state and federal Medicaid regulation.

## Quirks worth knowing

* **Rates are Medicaid rates** — generally the lowest of any payer. Model contribution margin including administrative cost before committing.
* **Magellan Healthcare** handles behavioral health for some plans — a carve-out requiring separate contracting
* **Ambetter marketplace plans** are a different product from the Medicaid plans, with different rates and separate contracting
* Administrative burden is high relative to reimbursement; this is a real business decision. See [Enroll in state Medicaid](/guides/enrollment/enroll-in-medicaid).


## Related topics

- [The US payer landscape](/concepts/payments/the-payer-landscape.md)
- [Payers vs insurance companies (they're not synonyms)](/concepts/payments/payers-vs-insurance-companies.md)
- [Enroll and contract with commercial payers](/guides/enrollment/enroll-with-commercial-payers.md)
- [Set up EDI, ERA, and EFT with each payer](/guides/enrollment/set-up-edi-era-eft.md)
- [File appeals](/guides/billing/file-appeals.md)
- [How to use the payer reference](/reference/payers/overview.md)
- [Payer enrollment & submission links](/reference/payers/enrollment-links.md)
- [Timely filing limits by payer](/reference/payers/timely-filing-limits.md)