Meridian

What Meridian does

Meridian is a Michigan-based managed care organization and wholly-owned subsidiary of Centene Corporation (NYSE: CNC), operating as a government-sponsored health plan since 1997. Headquartered in Detroit with 501-1,000 employees, Meridian delivers healthcare coverage across four product lines: the Meridian Medicaid Plan (core), MeridianComplete Medicare-Medicaid Plan (MMP), Wellcare by Meridian Medicare Advantage including an integrated D-SNP, and Ambetter from Meridian on the ACA Health Insurance Marketplace. Members are enrolled through state channels (Michigan ENROLLS, MI Bridges) or federal Marketplace platforms, with the Michigan Department of Health and Human Services serving as the primary contracted payer for Medicaid capitation revenue.

The underlying platform is a regulated managed care technology stack including member and provider web portals, a mobile application, claims processing systems, utilization management workflows, and FHIR-based Patient Access and Provider Directory APIs compliant with CMS-9115-F interoperability rules. The SDoH Assessment Tool integrates social determinants of health screening into the member portal, connecting members to 46 locally-based Community Health Workers covering every county in Michigan. Value-added service modules include the Start Smart for Your Baby maternal program, My Health Pays rewards program, disease management coaching, doula services via the Mae partnership, Pyx Health mental health support, and SafeRide non-emergency medical transportation.

Meridian's revenue model is built on recurring per-member capitation premiums from MDHHS for Medicaid, CMS for Medicare, and federal Marketplace premium subsidies for Ambetter plans. There are no co-pays or cost-sharing for Medicaid members. The go-to-market combines sales-led state contract acquisition with community-led engagement through embedded Community Health Workers and partnerships with schools, providers, and community-based organizations. NCQA Health Equity Accreditation and LTSS Distinction provide regulatory differentiation in serving vulnerable and complex-needs populations. Meridian operates exclusively within Michigan, with no disclosed plans for geographic expansion beyond the state.

Name

Meridian

Legal name

Meridian

Website

https://www.mimeridian.com/

Company type

Private

Founded year

1997

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Meridian is a Michigan-based managed care organization and Centene subsidiary providing Medicaid, Medicare-Medicaid, Medicare Advantage, and ACA Marketplace health plans to government-sponsored populations across all Michigan counties, supported by 46 embedded Community Health Workers.

Ownership category

akta.pro rank

Product category

Managed Care / Government-Sponsored Health Insurance

NAICS

Health Care and Social Assistance (62), Services for the Elderly and Persons with Disabilities (624120)

SIC

Services-Health Services (8000)

akta.pro primary industry

Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)

akta.pro secondary industries

Medicare Provider Networks & Delegated Medical Groups (MA-focused) (FSAIAGAK), Care Navigation, Referral & Digital Front Door Platforms (HLALABAH)

Keywords

• Managed care services
• Medicaid health plans
• Medicare advantage plans
• Government health insurance
• Community health programs

Headquarters

HQ city

Detroit

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales

Revenue model

1. Medicaid Managed Care Premiums: Meridian receives capitation payments from the Michigan Department of Health and Human Services (MDHHS) in exchange for providing healthcare coverage to Medicaid-eligible members. The state pays premiums on behalf of eligible members.
2. Medicare Advantage Premiums: Revenue from Medicare Advantage plans including Medicare Prescription Drug Plans under the Wellcare brand.
3. Medicare-Medicaid Plan (MMP) Premiums: Dual-eligible special needs plan combining Medicare and Medicaid coverage for individuals qualifying for both programs.
4. Health Insurance Marketplace Premiums: Revenue from Ambetter from Meridian plans offered through the Health Insurance Marketplace.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

Meridian is a Michigan-based managed care organization that delivers government-sponsored health insurance plans — including Medicaid, Medicare-Medicaid Plans (MeridianComplete), Medicare Advantage (Wellcare by Meridian), and Health Insurance Marketplace plans (Ambetter from Meridian). The company pairs these insurance products with value-added care management programs such as Start Smart for Your Baby (maternal health), My Health Pays rewards, Community Health Workers, Doula Services, Health Coaching, and the Pyx Health mental health support program, and operates member and provider digital portals along with FHIR-based interoperability APIs.

Product overview

Meridian is a Michigan Medicaid managed care organization and subsidiary of Centene Corporation offering a platform of health insurance products and integrated care services. The core products include the Meridian Medicaid Plan, Wellcare by Meridian (Medicare D-SNP), Ambetter from Meridian (Marketplace), and MeridianComplete (Medicare-Medicaid Plan). These insurance products are supported by value-added services including the Start Smart for Your Baby maternal program, My Health Pays rewards program, Health Coaching Programs (diabetes, heart, lung, lifestyle), Community Health Workers, Doula Services, and the Pyx Health mental health support program. Digital access is provided through Member and Provider web portals and mobile applications, all connected via FHIR-based APIs for interoperability.

Differentiator

Problem solved

Functional benefit

Products and services

• Meridian Medicaid Plan Michigan Medicaid managed care plan providing healthcare coverage and care management services to families, children, seniors, and individuals with complex medical needs who meet Michigan Medicaid eligibility rules.
• Wellcare by Meridian (Medicare D-SNP Plan) Medicare Dual Special Needs Plan (D-SNP) combining Medicare and Medicaid benefits for Michigan individuals eligible for both programs.
• Ambetter from Meridian (Health Insurance Marketplace Plan) ACA Health Insurance Marketplace plan for individuals and families purchasing coverage through the Affordable Care Act exchange in Michigan.
• MeridianComplete (Medicare-Medicaid Plan / MMP) Integrated Medicare-Medicaid Plan (MMP) for Michigan individuals eligible for both Medicare and Medicaid, providing coordinated coverage under a single plan.
• Start Smart for Your Baby Maternal and infant health program providing education, care management, and outreach support for pregnant members, new mothers, and their babies to reduce risks of premature births and NICU admissions.
• My Health Pays Rewards Program Member incentive program rewarding completion of healthy activities such as wellness exams, screenings, and vaccinations, with rewards usable for utilities, transportation, childcare, education, rent, and retail purchases.
• Health Coaching Programs Suite of disease management and lifestyle coaching programs including diabetes, heart health, lung health (asthma/COPD), and lifestyle management (weight, exercise, nutrition, stress, smoking cessation).
• Community Health Workers Program Program staffed by 46 locally-based Community Health Workers covering every county in Michigan's service area, conducting face-to-face visits to assist members with healthcare navigation and social determinants of health needs.
• Doula Services Coverage of doula visits during pregnancy, delivery, and up to one year postpartum, including emotional and physical support, prenatal education, birth plan assistance, and culturally competent care.
• Maternal Infant Health Program (MIHP) Home visiting program for Medicaid-eligible pregnant people and infants providing prenatal teaching, childbirth education, nutritional support, breastfeeding support, and referrals to community resources.
• Pyx Health Multi-program Mental health and social support program connecting members to compassionate staff, health plan benefits, and community resources through app-based or phone-based access.
• Health Insurance Portal Mobile App Mobile application for members to access their health insurance information, manage benefits, view claims, and connect with healthcare resources on-the-go.
• Member Portal Online portal for members to access their health records, manage benefits, view claims status, find providers, complete health assessments, and communicate with member services.
• Provider Portal Online portal for healthcare providers to submit prior authorizations, appeals, check claims status, access provider resources, training materials, and bulletins.

Quantifiable outcome

• Bronze Stevie Award for Sales & Customer Service in the 18th annual Stevie Awards for Sales & Customer Service
• +1 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration6 records

Feature3 records

Partnerships

Seven partnerships are on record, tiered core and supporting.

• Centene CorporationcoreOthersMeridian is a Centene Corporation company. Centene is a Fortune 500 healthcare enterprise committed to helping people live healthier lives through local brands and teams providing fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs.
• Delta DentalcoreTechnology or IntegrationMeridian partners with Delta Dental to provide dental coverage to Michigan Medicaid members. Delta Dental provides dental benefits through their Medicaid EPO Network. Children under 21 on Medicaid are covered through Healthy Kids Dental program with Delta Dental of Michigan or Blue Cross Blue Shield of Michigan.
• MaesupportingStrategic or Co-development PartnerMeridian partners with Mae, a digital health platform, to help connect members to doulas that match their cultural preferences. The partnership supports culturally competent maternal care through technology-enabled matching services.
• CentaurisupportingStrategic or Co-development PartnerMeridian has partnered with Centauri to help members find out if they may qualify for Supplemental Security Income (SSI) and to assist with the application process. Members can apply without affecting their Meridian benefits.
• SafeRidesupportingTechnology or IntegrationSafeRide provides non-emergency medical transportation services for Meridian members, including rides to medical appointments and gas mileage reimbursement through their online platform.
• Michigan 211supportingOthersMichigan 211 provides a searchable directory of over 27,000 programs for Michigan residents, integrated into Meridian's Community Resource Library to connect members with social services.
• Maternal Infant Health Program (MIHP) AgenciescoreStrategic or Co-development PartnerMeridian partners with MIHP agencies across Michigan to provide home visiting services for pregnant members including prenatal teaching, childbirth education, nutritional support, breastfeeding support, and newborn assessments.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Molina Healthcare: Molina Healthcare is a Fortune 500 managed care company specializing in Medicaid, Medicare, and Marketplace plans across multiple states, including Michigan. It is one of Meridian's most direct competitors in the Michigan Medicaid MCO market with a comparable product portfolio and government-program focus.
• UnitedHealthcare Community & State: UnitedHealthcare's Community & State segment is the largest U.S. Medicaid managed care operator and a direct competitor to Meridian in Michigan Medicaid, Medicare-Medicaid Plans, and Marketplace plans, with comparable member-facing technology and provider network models.
• Blue Cross Blue Shield of Michigan (Blue Cross Complete): Blue Cross Complete is BCBSM's Medicaid managed care subsidiary in Michigan, competing head-to-head with Meridian for Medicaid beneficiaries across the same counties. As the state's most established insurer brand, it is among Meridian's strongest in-state competitors.
• Aetna Better Health of Michigan: Aetna (CVS Health) operates Aetna Better Health as its Medicaid MCO arm, including Michigan. It is a direct peer offering Medicaid managed care to comparable populations with similar value-added services and provider contracting models.

Regional players

• Priority Health Choice: Priority Health is a Michigan-based regional health plan offering Medicaid (Priority Health Choice), Medicare, and commercial products in Michigan. It is a comparable regional competitor focused specifically on the same state as Meridian.
• McLaren Health Plan: McLaren Health Plan is a Michigan-based HMO owned by McLaren Health Care that offers Medicaid, Medicare Advantage, and commercial plans in Michigan. It is a comparable regional player competing in the same Michigan Medicaid market.
• HAP Empowered (Henry Ford Health): HAP Empowered is the Medicaid product of Health Alliance Plan, part of the Henry Ford Health system, operating in southeastern Michigan. It is a regional Michigan Medicaid competitor with a provider-integrated model similar to Meridian's value-based care positioning.

Broad incumbents

• Centene Corporation: Centene is Meridian's Fortune 500 parent and the largest U.S. Medicaid managed care company. While Meridian is one of many Centene state subsidiaries, Centene as a whole is the broad incumbent whose Medicaid playbook, technology platforms, and capital underpin Meridian's operations.
• Humana (CenterWell): Humana is a broad incumbent in Medicare Advantage and Dual Special Needs Plans — directly comparable to Meridian's Wellcare D-SNP and MeridianComplete MMP offerings — and competes with Meridian for dual-eligible and Medicare populations in Michigan and other states.
• Elevance Health (Anthem Blue Cross Blue Shield): Elevance Health operates Anthem-affiliated Medicaid plans across more than 20 states and competes broadly with Meridian in the government-sponsored managed care market, particularly in Marketplace (Ambetter-equivalent) and Medicare Advantage products.

Market position

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xtwitter.com/MeridianHP
• Facebookfacebook.com/MeridianHealthPlan
• LinkedInlinkedin.com/company/meridian-health-plan
• Instagraminstagram.com/meridian_hp

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments2 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Meridian