The North Carolina Department of Health and Human Services (NCDHHS) has announced a Medicaid Transformation rollout. Effective July 1, 2021 NCDHHS will transition most beneficiaries to the new NC Medicaid Managed Care. This transition will change the way many Mecklenburg County residents receive Medicaid services.
Under NC Medicaid Managed Care, beneficiaries will notice the following changes:
- Medicaid services will be administered and reimbursed by health plans.
- Beneficiaries will be able to choose a health plan and primary care provider (PCP). A new support system will be available to help beneficiaries make a choice and enroll in a plan that best suits their needs.
- Medicaid services will not change, but available health plans may offer enhanced services to plan members.
- Medicaid eligibility guidelines will not change because of Medicaid Transformation.
Statewide open enrollment for NC Medicaid Managed Care will be held March 15 – May 14, 2021. Mecklenburg County beneficiaries can enroll in one of five health plans (WellCare, UnitedHealthcare Community Plan, Healthy Blue, AmeriHealth Caritas, or Carolina Complete Health) and select a PCP through an Enrollment Broker. Residents can enroll by:
- Calling the Enrollment Call Center at 833-870-5500 (Sunday – Saturday, 7 a.m. – 8 p.m.)
- Visiting NCMedicaidPlans.gov
- Completing and returning a paper enrollment form by fax or mail
- Using the NC Medicaid Managed Care mobile app
If a plan is not selected during open enrollment, beneficiaries will be auto-enrolled in a health plan and PCP on May 15, 2021. Health plans are based on the beneficiary’s regional location. Enrollment Brokers can conveniently assist in choosing a health plan and PCP. Beneficiaries may also indicate a health plan and PCP preference in NC FAST (via ePASS application or caseworker entry).
Current beneficiaries will receive information by mail that outlines actions that need to be taken and who they can contact for assistance.
For additional information residents can visit NCMedicaidPlans.gov or contact the Enrollment Call Center at 833-870-5500.