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About NC Medicaid Managed Care

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NC Medicaid Managed Care is a new way to get the same Medicaid services that you have right now and it helps you get the most out of your Medicaid benefits.

Instead of one Medicaid program, there are many health plans to choose from. All health plans are required to have the same Medicaid services, such as office visits, blood tests and X-rays.

Health plans may also offer added services such as programs to help you quit smoking, eat healthier, and have a healthy pregnancy. 

Each plan has its own network of qualified doctors and health care professionals.

To keep your doctor, clinic or other provider, find out which plans they work with. Then choose one of those plans.

NC Medicaid Managed Care FAQs

Will I lose my Medicaid with these new changes?

No. The eligibility for Medicaid will remain the same.

Union County DSS will continue to process Medicaid applications and recertify individuals and families for Medicaid just as they do now.

Individuals and families that use Medicaid will now have the opportunity to choose from five health plans instead of just one.

Who will arrange my non-emergency medical transportation?

For beneficiaries enrolled in NC Medicaid Managed Care, your health plan will arrange your non-emergency medical transportation to your appointments.

If you are not enrolled in Medicaid Managed Care, Union County will continue to arrange your non-emergency medical transportation.

Which health plans do I get to choose from?

Call your health plan to learn more about your benefits.

Plan  Phone Number
EBCI Tribal Option* 1-800-260-9992 (TTY: 711)
WellCare 1-866-799-5318 (TTY: 711)
UnitedHealthcare Community Plan 1-800-349-1855 (TTY: 711)
HealthyBlue 1-844-594-5070 (TTY: 711)
AmeriHealth Caritas 1-855-375-8811 (TTY: 1-866-209-6421)
Carolina Complete Health** 1-833-552-3876 (TTY: 711 or 1-800-735-2962)

* EBCI Tribal Option is only available in Cherokee, Graham, Haywood, Jackson and Swain counties. Eligible members in the following counties may opt in: Buncombe, Clay, Henderson, Macon, Madison and Transylvania.

** Carolina Complete Health is only available in these counties: Alamance, Alexander, Anson, Bladen, Brunswick, Cabarrus, Caswell, Catawba, Chatham, Cleveland, Columbus, Cumberland, Durham, Franklin, Gaston, Granville, Harnett, Hoke, Iredell, Johnston, Lee, Lincoln, Mecklenburg, Montgomery, Moore, Nash, New Hanover, Orange, Pender, Person, Richmond, Robeson, Rowan, Sampson, Scotland, Stanly, Union, Vance, Wake, Warren, and Wilson.

How can my DSS Caseworker help me?

Your DSS Caseworker will only be able to put you in contact with the Enrollment Broker.

Your DSS Caseworker cannot tell you which plan to choose.

Your DSS Caseworker cannot enroll you in the health plan you choose.

Who can help me choose and enroll me into a health plan?

The Enrollment Broker is responsible for providing health plan counseling and enrollment assistance.

The Enrollment Broker will also give you information on NC Medicaid Managed Care to review.

The Enrollment Broker will be able to provide you with specific information on the health plans and help you to enroll.

Please remember that you decide which health plan to enroll in.

Contact the Enrollment Broker at 1-833-870-5500 (toll free).

Once I decide on a health plan, what do I do next?

Contact the Enrollment Broker in one of these ways or enroll:

  • Visit the NCDHHS Medicaid website to enroll.
  • Use the NC Medicaid Managed Care mobile app.
  • Call 1-833-870-5500 (TTY: 1-833-870-5588).
  • When you receive an enrollment form, fill it out and mail it in the envelope that came with the enrollment packet, or fax it to 1-833-898-9655.

Who can I call if I need help?

The Enrollment Broker is open from 7:00 a.m. to 5:00 p.m., Monday through Saturday. Call them at 1-833-870-5500 (TTY: 1-833-870-5588). During open enrollment, from March 15, 2021 through May 14, 2021, they will have extended hours from 7:00 a.m. to 8:00 p.m., seven days a week. The call is toll free.

You may need your Medicaid ID number when you call. If you do not speak English, the call center is still available to help you with a language assistance service. You can also use the chat feature on the NCDHHS Medicaid website to get answers to your questions.

Please keep in mind that because of the COVID-19 Pandemic, face-to-face contact with an Enrollment Broker will not be possible.

Will Union County DSS have information about NC Medicaid Managed Care available?

Yes, your caseworker and other employees within the agency can give you or direct you to information on NC Medicaid Managed Care.

Please remember that the Union County Staff cannot advise you or enroll you in your Health Plan.

For guidance on and enrollment in your Health Plan, please contact you Enrollment Broker at 1-833-870-5500.

You will also receive information on NC Medicaid Managed Care in the mail starting in March 2021.

Will everyone receiving Medicaid have to switch to NC Medicaid Managed Care?

There are a select few individuals who will not change from direct Medicaid at this time. You will receive a letter in the mail explaining if you must switch to NC Medicaid Managed Care, have the option to stay in direct Medicaid, or will be excluded from these changes until further notice.

It is very important that you read any mail you receive from NCDHHS so that you will know which category you or your family member(s) fall into.

The majority of individuals receiving Medicaid will fall into the mandatory category.

What steps do I need to follow to enroll in NC Medicare Managed Care?

Step 1:
Choose a primary care provider (PCP).

Health plans work with different PCPs. To keep your doctor, clinic or other health care provider as your PCP, find out which health plan they work with. You can also choose a new PCP. For a list of providers for each health plan, visit the NC Medicaid Managed Care website, use the NC Medicaid Managed Care mobile app, or call toll free at 1-833-870-5500 (TTY: 1-833-870-5588). If you do not choose a PCP, your health plan will choose one for you.

Step 2:
Choose a health plan.

View the health plans and choose the best one for you. These are the health plans available in NC Medicaid Managed Care:

  • EBCI Tribal Option*
  • Healthy Blue
  • Well Care
  • AmeriHealth Caritas
  • United Healthcare Community Plan
  • Carolina Complete Health*

* EBCI Tribal Option and Carolina Complete Health are not offered in all counties.

Click here to see the plans available in your county.

Once you have reviewed all of the options, click here to enroll in a health plan.

Note: . If you do not choose a health plan, one will be chosen for you.

Step 3:
Enroll in a health plan.

Contact the Enrollment Broker in one of these ways or enroll:

  • Visit the NCDHHS Medicaid website to enroll.
  • Use the NC Medicaid Managed Care mobile app.
  • Call 1-833-870-5500 (TTY: 1-833-870-5588).
  • When you receive an enrollment form, fill it out and mail it in the envelope that came with the enrollment packet, or fax it to 1-833-898-9655.

After you enroll, you will receive information and an ID card. You will use your ID card to get health services.

Important Dates to Remember

Open Enrollment:

March 15 - May 14, 2021

Auto Enrollment:

Begins May 15, 2021

NC Medicaid Managed Care Go Live Date in Union County:

July 1, 2021

Tips for a Successful Transition

  • Start learning early about the new Medicaid changes and make sure that your DSS Caseworker has your most updated address, phone number and email address.
  • Contact the Enrollment Broker at 1-833-870-5500 with any questions related to enrolling in NC Medicaid Managed Care.

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