Managed Medicaid

Cambios al programa Medicaid de NC

Si usted recibe beneficios del programa Medicaid de Carolina del Norte, es posible que deba seguir algunos pasos.

MÁS INFORMACIÓN SOBRE EL PLAN ADMINISTRADO DE MEDICAID

North Carolina Medicaid transitioned to Managed Medicaid. Most people who receive Medicaid benefits either choose or were assigned a health plan in the NC Medicaid Managed Care program. This includes:

  • Most families and children
  • Children who get NC Health Choice
  • Pregnant women
  • People who are blind or disabled and do not get Medicare

Some people who receive benefits through NC Medicaid remained on Medicaid Direct. This includes people who:

  • Also receive benefits through Medicare
  • Need certain services to address needs related to developmental disability, behavioral health, traumatic brain injury or substance use disorder

For more information of who is required to choose a health plan, please visit https://ncmedicaidplans.gov/learn/who-must-choose-health-plan.

 

 

 

 

Important Information About the State's New Medicaid Program

Which Medicaid plans does NHRMC accept?

We are currently in network with the following Managed Medicaid plans:

  • AmeriHealth Caritas of NC
  • Blue Cross Blue Shield NC Healthy Blue
  • Carolina Complete Health
  • United Healthcare NC Community Plan
  • WellCare of NC
  • Medicaid Direct

What do I need to do?

  • Review the plan you are enrolled with and familiarize yourself with its benefits
  • Make sure your assigned primary care provider listed on your new Medicaid insurance card is correct
  • If needed, request any changes to your plan or assigned primary care provider using the steps in the next sections.

How can I change my Medicaid plan?

If you need to change your assigned health plan, you can do so for any reason within 90 days of your plans start date. After the 90 days, you can request to change your plan if the reason meets certain criteria. Reasons for changes are listed on the Health Plan Change Request form found at www.ncmedicaidplans.gov.

To request a change to your health plan, please call the NC Medicaid Contact Center using one of the following options:

Phone: 1-833-870-5500 (TTY: 711 or RelayNC.com)

Online: Go online at ncmedicaidplans.gov 

Paper: Complete and return a paper enrollment form by fax or mail  

Mobile App: Use the NC Medicaid Managed Care mobile app

How can I change my assigned primary care provider?

To change your assigned PCP, you will need to contact your Medicaid plan servicer using the designated phone number below:
 
AmeriHealth Caritas of NC: 1-855-375-8811
24 hours a day, 7 days a week
 
BCBS Healthy Blue: 1-844-594-5070
7am – 6pm, Monday through Saturday
 
Carolina Complete: 1-833-552-3876
7am – 6pm, Monday through Saturday
 
United Healthcare NC Community Plan: 1-800-349-1855
7am – 6pm, Monday through Saturday
 
WellCare of NC: 1-866-799-5318
7am – 6pm, Monday through Saturday
 
If you are unable to find your primary care provider in the online directory, please check the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool again later. Health plans add new providers to their networks on a daily basis, so please continue to check the Provider Lookup Tool.

Who can I call to get help?

The NC Medicaid Contact Center is available to help answer any questions you have and help you choose or change your primary care provider (PCP) and health plan. The call is toll free and is available in other languages. 

Phone: 1-833-870-5500 (TTY: 711 or RelayNC.com)

Hours of operation: 7 a.m. to 5 p.m., Monday through Saturday

For answers to common questions, visit the NC Medicaid’s FAQ page.