Standard plans provide integrated physical health, behavioral health, pharmacy and long-term services and support to most Medicaid beneficiaries, as well as other programs and services that address unmet health-related resource needs
Understanding the Transition to Managed Care
Some people can change their health plan at any time. You can change your health plan at any time for these reasons: * You need services to address a mental health disorder, substance use disorder, intellectual/developmental (I/DD) or traumatic brain injury (TBI) * You are a federally recognized tribal member or qualify for services through […]
Make sure your local Department of Social Services (DSS) has your current mailing address, phone number and email address so you get all important notices about this change (especially if your contact information has changed due to COVID-19). Visit ncmedicaidplans.gov or call 833-870-5500 to learn more. You can also stay up-to-date by using the free […]
You have the right to: * Get free advice over the phone from the NC Medicaid Enrollment Broker Call Center, where someone can inform you whether you have to enroll in a health plan, and help you decide which health plan is the best choice for you and your family. * Get information in your […]
Coverage under the NC Medicaid Managed Care program begins July 1, 2021. If you did not choose a health plan or request to stay in NC Medicaid Direct by May 21, 2021, you were automatically enrolled in a health plan to ensure you could continue to get care. Most people were able to keep their […]
The Eastern Band of Cherokee Indians (EBCI) Tribal Option is a health plan managed by the Cherokee Indian Hospital Authority (CIHA) to meet the primary care coordination needs of federally recognized Tribal members and others eligible for services through Indian Health Service (IHS). Only IHS-eligible beneficiaries associated with the EBCI can participate in this health […]
Most NC Medicaid beneficiaries have been enrolled in the NC Medicaid Managed Care program. Some people will stay in NC Medicaid Direct. They will not need to choose a health plan. Those who are now in managed care should have received a new Medicaid ID card and other important information from their new health plan. […]
Some people will not need to choose a health plan because of the type of health services they need. They will stay enrolled in NC Medicaid Direct. For example, individuals who receive Innovations Waiver services, Traumatic Brain Injury (TBI) Waiver services or Community Alternatives Programs for Children or Disabled Adults (CAP/C or CAP/DA) services will […]
In July 2021, most people in North Carolina with Medicaid saw a change in how they receive their health care. If you have NC Medicaid, you may have received a letter asking you to enroll in a health plan. If you didn’t pick a health plan by the deadline, the State chose one for you […]
NC Medicaid Direct is North Carolina’s health care program for Medicaid beneficiaries who are not enrolled in health plans. It includes care management by Community Care or North Carolina (CCNC), for physical health services. Four Local Management Entity-Managed Care Organizations (LME-MCOs) coordinate services for mental health disorder, substance use disorder, intellectual/developmental (I/DD) or traumatic brain […]
