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Questions and Answers About NC Medicaid Transformation

North Carolina’s Medicaid program is changing, and most Medicaid patients will need to enroll in a new Medicaid plan during the open enrollment period that began on October 14, 2019. Here’s what you need to know about the changes and how to know which of the new health insurance plans include Atrium Health doctors and hospitals.


How do I know if my Atrium Health doctor is in a new Medicaid health insurance plan?

As of November 15, 2019, Atrium Health doctors and hospitals are in-network for the following NC Medicaid plans:

  • NC Medicaid Direct
  • Carolina Complete Health

Visit this website for updates on Atrium Health’s participation in NC Medicaid health insurance plans or call 844-933-1234 .

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, regardless of their health insurance plan or ability to pay for emergency services.


Why choose Atrium Health?

When you choose a health insurance plan that includes Atrium Health you get:

  • World-class care from experts at Levine Cancer Institute, Levine Children's Hospital, Sanger Heart & Vascular Institute and more.
  • Access to primary care, on-demand care including urgent care, and the region's only Level I trauma center.

How to Enroll in or Change Medicaid Plans

To enroll in a Medicaid plan or to change your plan, you can:

  • Go to NCMedicaidPlans.gov
  • Use the NC Medicaid Managed Care mobile app
  • Call NC Medicaid toll free at 1-833-870-5500 (TTY: 1-833-870-5588)
  • When you receive an enrollment form, fill it out and mail or fax it back

Frequently Asked Questions

North Carolina’s Medicaid program is changing from a state-run program to a managed care model that will include five new Medicaid health insurance plans, called Prepaid Health Plans (PHP).

Under the new Medicaid Managed Care program, most but not all Medicaid patients will need to pick one of the new five health insurance plans and select a primary care provider (PCP)/doctor office. All of the plans offer the same basic health care benefits and services. However, the doctors and hospitals included in each health insurance plan may be different. The PHPs also offer different non health care related services.

  • Atrium Health cannot recommend a specific plan to you.
  • As of November 15, 2019, Atrium Health doctors and hospitals are in-network for the following NC Medicaid plans:
    • NC Medicaid Direct
    • Carolina Complete Health
  • As of November 15, 2019, Atrium Health doctors and hospitals are in-network for the following NC Medicaid plans:
    • NC Medicaid Direct
    • Carolina Complete Health
  • You can call Atrium Health at 844-933-1234 to confirm which health plans your doctor participates in.
  • Visit this website for updates on Atrium Health’s participation in the new NC Medicaid health insurance plans.

Open enrollment for most NC Medicaid patients in the Metro Charlotte area begins October 14 and runs through December 13, 2019. New coverage for patients required to select a new NC Medicaid health plan is scheduled to begin February 1, 2020.

  • You can change your new Medicaid health plan until December 13, 2019.
  • Then, in the first 90 days after your new Medicaid health plan begins, you can change your health plan for any reason.
  • After that, unless you have a special reason, you cannot change your health plan until your Medicaid anniversary date.
  • To change your new Medicaid plan, call 1-833-870-5500.

If you have questions now, contact the North Carolina Department of Health & Human Services by:

  • Calling toll free at 1-833-870-5500 (TTY: 1-833-870-5588), 7 a.m. to 5 p.m., Monday through Saturday.
  • Visiting NCMedicaidPlans.gov and using the “chat” tool to ask questions.

It depends. Most people in NC Medicaid must choose a new Medicaid health plan. Some people can stay in NC Medicaid Direct. They will not need to choose a new plan. To find out if you must enroll, go to “Who must enroll in NC Medicaid Managed Care? Or go to NC Medicaid website. Members who need to enroll in a new health insurance plan will also receive an enrollment packet in the mail sometime shortly after October 1, 2019.

If you need to enroll in a new Medicaid health plan and do not select one, the state will select a new Medicaid health plan for you.

If you still have questions, call toll free at 1-833-870-5500 (TTY: 1-833-870-5588). Or use the chat tool to chat with an enrollment agent online.

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