Nevada's poor and uninsured who qualify for Medicaid will likely have a choice between Anthem Blue Cross and Blue Shield and Health Plan of Nevada, a subsidiary of Sierra Health Services, to provide them with managed health care.

The state's Purchasing Division notified both insurance giants on Thursday of its intent to award both of them with Nevada's Medicaid contract, totaling about $500 million. Roughly 105,000 Nevadans are enrolled in the state's Medicaid program.

Medicaid is a collection of state programs for low-income people in need of health care.

Similar notices were sent to Anthem and Sierra in November. Those were rescinded after an error in scoring was discovered, prompting a redo of the evaluation process, said Greg Smith, an administrator for the state's Purchasing Division.

A total of five companies were vying for the managed-care Medicaid contract. Only two were to receive them, officials said.

While the state re-evaluated the companies, the current contract, which was to expire June 30, was extended for 90 days, Smith said. Health Plan of Nevada and NevadaCare, a subsidiary of i/mx Cos. in Arizona, hold the current contract.

NevadaCare, Amerigroup Nevada, a subsidiary of Virginia-based Amerigroup Corp., and Molina Healthcare of Nevada, a subsidiary of Molina Healthcare in California, were the other three companies that put in bids for the 2006 contract.

Smith said the next step is to negotiate with Anthem and Health Plan of Nevada, which he anticipates will take about two to three weeks.

"In general terms, if you're a Medicaid recipient, you should know that these companies went through a pretty rigorous evaluation, and our evaluators found their services to be superior,'' Smith said on Monday. "The award is subject to the negotiations of final contract terms and specifications as well as approval from the state Board of Medical Examiners.''

Once the contracts are signed and the parties are notified, the unsuccessful companies have 10 days to file a protest. At that time, the companies' evaluations will be available for review.

Officials from both Anthem and Sierra said they were excited about the opportunity to provide care to Nevada's Medicaid recipients and children who qualify for Nevada Check Up, the state's children's health insurance program.

It provides low-cost, comprehensive health-care coverage for low-income, uninsured children up to age 18 who are not covered by private insurance or Medicaid.

Anthem officials said the company expects to enroll about 50,000 Medicaid recipients in the first full year of operation and plans to staff several community resource centers in Las Vegas and Reno. The centers will provide health education, referral and translation services and other specialized assistance to those in need.

The company's focus will be on smoking cessation and asthma disease management programs, said Sally Vogler, a spokeswoman for Anthem.

Anthem estimates that nearly 40 percent of the state's Medicaid recipients are smokers.

Sierra's Health Plan of Nevada, which has held the state's Medicaid contract for nine years, has approximately 55,000 Medicaid members enrolled and about 12,800 children under the Nevada Check Up program.

"We have been instrumental in developing a couple of programs over the last nine years, including a dental program,'' said Peter O'Neill, a spokesman for Sierra Health Services. "We've focused a great deal of time on high-risk pregnancies through our obstetrics and gynecology practice at Southwest Medical Services.''

O'Neill said people who qualify for Medicaid can choose between Nevada Health Plan and Anthem. But once an insurance provider has reached a certain number of members, Medicaid recipients will automatically be assigned to the other plan.

"No plan can actually get more than 55 to 60 percent of the members,'' O'Neill said.