Can the NC Medicaid Ombudsman help me appeal if I am denied care?

The NC Medicaid Ombudsman cannot provide legal advice or represent you in your appeal. However, if you have already talked with your health plan and were not able to resolve your issue, we can contact your health plan to try to resolve your issue informally. For example, we can give your health plan new information, and ask your health plan to change their decision or find another solution to the problem. We can help you understand how to file your own appeal with the health plan, and what things you can do to get the health plan to change its decision.

If our assistance doesn’t resolve your issue or you want legal representation instead of informal assistance, we can refer you to your local legal services office who may be able to handle your appeal for free.