When can I switch health plans?

You can change your health plan for up to 90 days after the start date shown on your health plan enrollment letter. After 90 days, you cannot change your health plan until your next recertification date unless you have a special reason. You can change your health plan at any time for these reasons:

  • You moved out of your health plan’s area.
  • You need a service that your health plan does not cover for moral or religious reasons.
  • Your health plan says you need multiple services they cannot provide and your PCP says you need services right away.
  • You need services that meet specific needs, such as developmental disability, behavioral health, traumatic brain injury or substance use disorder.
  • You are a federally recognized Tribal member or qualify for Indian Health Services (IHS).
  • Every year at your recertification, you will be given a 90-day period to change your health plan.

You can find more information about what this means by clicking here or by calling the NC Medicaid Enrollment Broker at 833-870-5500. The call is toll free.