​Medicaid Transformation

OPEN ENROLLMENT FOR NC MEDICAID MANAGED CARE ENDS MAY 21, 2021
CHOOSE YOUR PATH TO BETTER HEALTH!

Residents who were unable to attend the NC Medicaid Managed Care virtual town hall on May 14 can watch the recording here. Hundreds of participants tuned in to learn about the available health plans and enrollment process. Questions and answers from the event can be downloaded here. 

Effective July 1, 2021 the North Carolina Department of Health and Human Services (NCDHHS) will transition most beneficiaries to the new NC Medicaid Managed Care. If a plan is not selected during open enrollment, beneficiaries will be auto-enrolled in a health plan and PCP on May 22, 2021. Enrollment is quick and easy!

To review the health plans or enroll, please go to ncmedicaidplans.gov/find/viewhealthplans or call 1-833-870-5500.  Services are available in English and Spanish.

Mecklenburg County beneficiaries can select a PCP through an Enrollment Broker and enroll in one of the following health plans:  

• WellCare - https://www.wellcare.com/North-Carolina/Providers/Medicaid
  
• UnitedHealthcare Community Plan - https://www.uhcprovider.com/en/health-plans-by-state/north-carolina-health-plans/nc-comm-plan-home/nc-cp-training.html
  
• Healthy Blue - https://provider.healthybluenc.com/north-carolina-provider/manuals-and-guides
  
• AmeriHealth Caritas - https://www.amerihealthcaritasnc.com/provider/forms/index.aspx
  
• Carolina Complete Health - https://network.carolinacompletehealth.com/resources/manuals-and-forms.html
  

There will also be an Enrollment Broker, Maximus, who can conveniently assist Medicaid recipients in choosing a health plan and PCP.

In addition, there will also be an Ombudsman that will assist beneficiaries with support who have challenges navigating this new process. Below are some attachments regarding the Ombudsman to assist beneficiaries:

NC Medicaid Ombudsman poster (English)
NC Medicaid Ombudsman poster (Spanish)
NC Medicaid Ombudsman flyer (English)
NC Medicaid Ombudsman flyer (Spanish)
NC Medicaid Ombudsman brochure (English)
NC Medicaid Ombudsman brochure page 1, page 2 (Spanish)

Health plans are based on the beneficiary's regional location. Beneficiaries may also indicate a health plan and PCP preference in NC FAST (via ePASS application or caseworker entry). Current beneficiaries will receive information by mail that outlines actions that need to be taken and who they can contact for assistance.

Under NC Medicaid Managed Care, beneficiaries will notice the following changes:

• Medicaid services will be administered and reimbursed by health plans.
• Beneficiaries will be able to choose a health plan and primary care provider (PCP). A new support system will be available to help beneficiaries make a choice and enroll in a plan that best suits their needs.
• Medicaid services will not change, but available health plans may offer enhanced services to plan members.
• Medicaid eligibility guidelines will not change because of Medicaid Transformation.

Residents can enroll by:    

• Calling the Enrollment Call Center at 833-870-5500 (Sunday – Saturday, 7 a.m. – 8 p.m.)
• Visiting NCMedicaidPlans.gov
• Completing and returning a paper enrollment form by fax (833-898-9655) or mail (NC Medicaid, PO Box 613, Morrisville, NC 27560)
  
• Using the NC Medicaid Managed Care mobile app (search for NC Medicaid Managed Care on Google Play or the App Store)
  

For additional information residents can visit NCMedicaidPlans.gov or contact the Enrollment Call Center at 833-870-5500.

Get answers to frequently asked questions at https://ncmedicaidplans.gov/learn/get-answers. 

Download the fact sheet.

Download the flyer here (English) or here (Spanish).