Open enrollment starts for NC Medicaid Managed Care

North Carolina

WNCT

RALEIGH, NC (WNCT) – North Carolina officials said open enrollment for Medicaid Managed Care began statewide on Monday.

According to the state Department of Health and Human Services, open enrollment has expanded from the initial 27 counties that launched mid-July to all 100 counties, covering an additional 860,000 people.

Open enrollment ends for everyone on December 13 and coverage is scheduled to begin February 1, 2020.

Enrollment packets were mailed over the last two weeks to the remaining 73 counties in managed care regions 1, 3, 5 and 6.

Packets include a letter, enrollment form, information sheet, comparison chart, and a postage-paid envelope.

The NC Medicaid Managed Care enrollment website, and the NC Medicaid Managed Care Mobile App, available on Google Play and the Apple App Store, allows people to explore their options, enroll in a health plan, and select a primary care provider.

Additionally, people can call the NC Medicaid Managed Care Call Center at 833-870-5500, to speak with enrollment specialists who are independent of the health plans.

These specialists can help people find the health plan that is best for them and their families.

Earlier this year, the state Department of Health and Human Services awarded contracts to five health plans.

All health plans are required to have the same Medicaid services, such as office visits, blood tests, and X-rays.

Health plans also have added services such as gym memberships and healthy pregnancy programs.

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

In 2015, the NC General Assembly enacted legislation directing the Department of Health and Human Services to transition Medicaid and NC Health Choice from fee-for-service to managed care.

Under managed care, the Department contracts with insurance companies, which are paid a predetermined set rate per person to provide all services.

Transforming North Carolina’s Medicaid program to managed care is the most significant change made since its inception.

For questions about open enrollment, call the NC Medicaid Managed Care Call Center at 833-870-5500, or visit their website.

For general information about the transformation to managed care, email Medicaid.Transformation@dhhs.nc.gov.

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