Things to know for Medicaid beneficiaries

Things to know about NC Medicaid Managed Care

On July 1, 2021, most NC Medicaid beneficiaries will receive the same Medicaid services in a new way called NC Medicaid Managed Care. Beneficiaries will receive care through a health plan's network of doctors. The health plans mailed welcome packets to beneficiaries moving to Managed Care that include new Medicaid ID cards. Some beneficiaries will not enroll with health plans and will remain in NC Medicaid Direct. You can find more information about the health plans and also get answers to questions about NC Medicaid Managed Care in the Beneficiary Help Center.

Frequently Asked Questions

Is NC Medicaid eligibility changing?
NC Medicaid eligibility rules are not changing. If you have questions about your eligibility, contact your local Department ofSocial Services (DSS) office. Contact information is available at ncdhhs.gov/localDSS.

What if I have questions about my Primary Care Provider?
If you have questions about your PCP or want to change PCPs, contact your health plan at the number on your new
ID card.

Does my new health plan cover my medicines? 
Your medications are still covered in NC Medicaid Managed Care. Prescription copays for all health plans will remain the same as they were in NC Medicaid Direct. If you have questions, contact your health plan. 

How do I change my health plan? 
If you want to change your health plan, please contact the Enrollment Broker at 833-870-5500 (TTY: 833-870-5588) or go to NCMedicaidPlans.gov.

How do I schedule a ride to a doctor's appointment?
You can schedule a ride to your medical appointment by calling your health plan at the number on your new Medicaid ID card.  

• AmeriHealth Caritas − ModivCare (NEMT Broker): 833-498-2262
• Carolina Complete Health − ModivCare (NEMT Broker): 855-397-3601
• Healthy Blue − ModivCare (NEMT Broker): 855-397-3602
• UnitedHealthcare − ModivCare (NEMT Broker): 800-349-1855
• WellCare − One Call (NEMT Broker): 877-598-7602
• NC Medicaid Direct and EBCI Tribal Option − Contact your local DSS: 704-920-2246

What if I have more questions? 

1. Check to see what health plan you are enrolled in. You can find this in the welcome kit you got in the mail, as well as on your new Medicaid ID card. If you have questions or did not get a welcome kit, call the Enrollment Broker at 833-870-5500.

2. Call your health plan with questions about benefits and coverage. The Member Services number is on your new Medicaid ID card.

• AmeriHealth Caritas: 855-375-8811 
• WellCare: 866-799-5318
• Healthy Blue: 844-594-5070 
• Carolina Complete Health: 833-552-3876
• UnitedHealthcare Community Plan: 800-349-1855 
• EBCI Tribal Option: 800-260-9922

You may also visit the NC Medicaid Beneficiary Help Center.

3. Contact the NC Medicaid Ombudsman if you have questions you have been unable to resolve with your health plan. Call 877-201-3750 or visit ncmedicaidombudsman.org.