There is a New Way to get Medicaid Health Care

Most people will get the same Medicaid services in a new way – through health plans. You will be able to choose the health plan that is best for you. You will also choose a primary care provider (PCP).

 

What you need to do

  1. Choose a primary care provider (PCP):
    To keep your doctor, clinic or other health care provider as your PCP, find out which health plan they work with. You can also choose a new PCP. For a list of doctors for each health plan, visit the website, use the mobile app or call us toll free.
  2. Choose a health plan in NC Medicaid Managed Care: A health plan is a group of doctors, hospitals and other providers. They work together to give you the health care you need. There are several health plans to choose from. Learn more: https://ncmedicaidplans.gov/choose
  3. Enroll in one of these ways:
    • Go to ncmedicaidplans.gov
    • Use the NC Medicaid Managed Care mobile app
    • Call toll free at 1-833-870-5500 (TTY: 1-833-870-5588)
    • When you receive an enrollment form, fill it out and mail or fax it back

 

If you have more questions

  • About your eligibility: Contact your local Department of Social Services (DSS) office. Find contact information here: ncdhhs.gov/localdss
  • About choosing or enrolling in a health plan: Go to ncmedicaidplans.gov (chat feature available), use the NC Medicaid Managed Care mobile app or call toll free at 1-833-870-5500 (TTY: 1-833-870-5588)
  • About your health plan or benefits: Call your health plan. Find contact information here: ncmedicaidplans.gov/choose/compareplans

Open enrollment began on July 15 for 540,000 Medicaid recipients in 27 counties in North Carolina who will be transitioning from fee-for-service to a managed care system. Enrollees will be asked to select from a number of pre-paid health plans administered by private entities contracting with the state and physicians. The pre-paid health plans will have member services staff who will be able to answer questions, and the members can also access care managers who are people who can work one-on-one with individuals to understand their health conditions and get referred to the right physicians.

Any Medicaid recipients who do not enroll by the Sept. 13 deadline will be assigned to a health plan. After a person is assigned a health plan, they can still change. Individuals will have 90 days from Nov. 1  to make a change. The new system launches Nov. 1 in those 27 counties. All 100 counties are expected to be switched into managed care by next February.

People who need assistance signing up for the new system can call 833-850-5500.