How and when do I choose a health plan?

Each Standard health plan works with a network, or group of doctors, hospitals and other health care providers.  You should choose a health plan that will let you keep going to your doctors and other health care providers. All health plans offer the same basic benefits and services. Some may also offer added services. When choosing a Standard health plan, you may want to ask:

  • How do I keep my current doctors, hospitals and specialists?
  • What are my choices if I change doctors?
  • What added services does each health plan have?
  • You can learn more about what health plans are available to you and the services they provide by visiting ncmedicaidplans.gov or calling 833-870-5500.

If you are new to Medicaid, you can get help in plan selection/change in one of the following ways:

  • Call 833-870-5500 (toll-free)
  • Go to ncmedicaidplans.gov
  • Complete and return a paper enrollment form by fax or mail
  • Use the NC Medicaid Managed Care mobile app

If you want to change your health plan, you can do so for up to 90 days after the start date shown on your health plan enrollment letter. After 90 days, you must wait until your next recertification (renewal) date to change your health plan unless you have a special reason.* Learn more about special reasons for changing your health plan. The Ombudsman can help you figure out if you can change your health plan. Call us at 877-201-3750 for help.

*Note: There is only one Tailored Plan in each county. Beneficiaries eligible for a Tailored Plan will be assigned the plan that serves the county where they get their Medicaid.