What You Need to Know About NC Medicaid Changes
North Carolina’s Medicaid program is changing. Most NC Medicaid and NC Health Choice patients will have the chance to enroll in a new Medicaid plan and choose their primary care provider (PCP) during open enrollment from March 15, 2021 to May 14, 2021. We’ll cover what you need to know about the changes. This includes how to know which of the new health plans include Atrium Health doctors and hospitals in the Charlotte Metro Area.
How do I know if my Atrium Health doctor is in a new NC Medicaid health plan?
As of April 8, 2021, Atrium Health doctors and hospitals in the Charlotte Metro Area are in-network for the NC Medicaid plans below:
- HealthyBlue
- Carolina Complete Health
- WellCare
- NC Medicaid Direct
“In-network” means that Atrium Health will accept the plan. Visit this website often for updates to see which NC Medicaid plans will be accepted at Atrium Health.
Looking for information on Wake Forest Baptist Health doctors and hospitals? Learn which NC Medicaid plans have them in their network.
Important: If you have a medical emergency, you should go to the closest hospital emergency room. Atrium Health hospitals provide services to all patients seeking treatment for an emergency medical condition. It doesn’t matter what health insurance plan you have or if you can pay for emergency services.
Why choose Atrium Health?
When you choose a health plan that includes Atrium Health you get:
- The very best care from experts at Levine Cancer Institute, Levine Children's, Sanger Heart & Vascular Institute and more.
- Access to award winning hospitals:
- Atrium Health Carolinas Medical Center – Named a Best Hospital by U.S. News & World Report for 4 years in a row
- Atrium Health Levine Children’s Hospital – Named a Best Children’s Hospital for 13 years in a row, and nationally ranked in 8 pediatric subspecialties
- Access to the region’s largest primary care network. We have nearly 200 doctor’s offices, over 30 urgent care locations and virtual care options for all ages.
Key Dates
-
Open enrollment begins:
March 15, 2021 -
Open enrollment ends:
May 14, 2021 -
New Medicaid coverage begins:
July 1, 2021
How to Enroll in or Change NC Medicaid Plans
Starting March 15, 2021, here are the ways people who are eligible (qualify) can choose their health plan and their primary care provider (PCP):
- Online: Go to NCMedicaidPlans.gov to enroll online using a computer
- Mobile App: Enroll from your smart phone (Android or iPhone). To get the app, search for NC Medicaid Managed Care on Google Play (Android) or the App Store (iPhone).
- Phone: Calling NC Medicaid toll free at 1-833-870-5500 (TTY: 1-833-870-5588)
- Mail or fax: Fill out and send your enrollment form back (by mail or fax)
Frequently Asked Questions
North Carolina’s Medicaid program is changing. It will go from a state-run program to a managed care model. Managed care models are designed to better manage costs, use and quality of health care services. The new program will include 5 new Medicaid health plans, called Prepaid Health Plans (PHP).
Under the new Medicaid Managed Care program, most but not all NC Medicaid and NC Health Choice patients will need to:
- Pick 1 of the 5 new health plans
- Choose a Primary Care Provider (PCP) and the office address you see them at
All of the plans offer the same basic health care benefits and services. However, the doctors and hospitals included in each health plan may be different. The health plans also offer different non health care related services.
- Atrium Health cannot recommend a specific plan to you.
- As of April 8, 2021, Atrium Health doctors and hospitals in the Charlotte Metro Area are in-network for the following NC Medicaid plans:
- HealthyBlue
- Carolina Complete Health
- WellCare
- NC Medicaid Direct
It depends. Most people in NC Medicaid and NC Health Choice must choose a new Medicaid health plan. Some patients can stay in NC Medicaid Direct, and will not need to choose a new plan. To find out if you must enroll, go to “Who must choose a health plan?" Or go to the NC Medicaid website. Members who need to enroll in a new health plan will also receive an enrollment packet in the mail sometime after March 1, 2021.
If you need to enroll in a new NC Medicaid health plan and do not select one, the state will select a new NC Medicaid health plan for you.