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Medicaid managed care

Changes are ahead for North Carolina’s Medicaid program

If you receive benefits under North Carolina’s Medicaid program, you should know about upcoming changes. Most enrollees must choose a health plan as the state shifts to managed care. Look for a letter from the state that tells you whether you are eligible for managed care.

Novant Health Medical Group participates in the following managed care plans:

  • AmeriHealth Caritas NC
  • Carolina Complete Health
  • Healthy Blue
  • UHC Community Plan
  • WellCare of NC and Medicaid Direct

Five things to know about the state’s new Medicaid program

NC Medicaid Managed Care helps you get the most out of your Medicaid benefits. Instead of one Medicaid program, you can choose from health plans.

  • Each health plan has the same Medicaid services, such as office visits, blood tests and X-rays.
  • Health plans may also offer added services such as programs to help you quit smoking, eat healthier and have a healthy pregnancy.

° See a list of added services by health plan visit.

  • Each plan has its own network of qualified doctors and healthcare professionals.

Your new health plan becomes effective July 1.

  • Open enrollment (where you choose your plan and doctor) continues through May 14.
  • If you do not choose a health plan and a doctor by May 14, one will be chosen for you beginning May 15.
  • You have until Sept. 30 to change your health plan for any reason.
  1. Choose a primary care provider (PCP). That can be a doctor, physician assistant or nurse practitioner.
    1. Visit ncmedicaidplans.gov/.
    2. Use the NC Medicaid Managed Care mobile app.
    3. Call toll free 833-870-5500 (TTY: 833-870-5588).
  2. Choose a health plan.
    1. Visit ncmedicaidplans.gov/find/viewhealthplans.
  3. Enroll in a plan.
    1. Chat with an enrollment specialist at ncmedicaidplans.gov.
    2. Use the NC Medicaid Managed Care mobile app.
    3. Call toll-free 833-870-5500 (TTY: 833-870-5588).
    4. Fill out and mail or fax in a paper enrollment form you’ll receive in the mail.
  4. If you do not choose a health plan, one will be chosen for you.
    1. You know your healthcare needs, so it’s better if you choose.
  5. Watch a video that explains what you need to do.

Health plans add new healthcare providers to their networks on a daily basis. Please check the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool again soon.

Call the enrollment site’s customer service center toll-free at 833-870-5500 (TTY: 833-870-5588). You may need your Medicaid ID number when you call. If you speak a language other than English, the call center can still help you using a language assistance service.

See more frequently asked questions to learn about your Medicaid benefits as North Carolina transitions its program to managed care.

Key dates for transitioning to Medicaid Managed Care
  • March 15, 2021 – open enrollment for beneficiaries begins
  • May 14, 2021 – open enrollment ends
  • May 15, 2021 – auto-enrollment beings for beneficiaries who have not selected a health plan
  • July 1, 2021 – Medicaid Managed Care launch
  • September 30, 2021 – deadline to make a health plan change
  • Changes to PCP can be made twice a year for any reason

Eligibility for Medicaid managed care

Medicaid eligibility rules will remain unchanged at this time. If you have questions about eligibility, contact your local department of social services. Find contact information at ncdhhs.gov/localdss.