North Carolina Medicaid

The 2023 Consolidated Appropriations Act (Omnibus Bill), signed into law Dec. 29, 2022, included an important change to the federal COVID-19 Public Health Emergency (PHE) period: Starting April 1, 2023, Medicaid programs are no longer required to provide continuous coverage for beneficiaries. (According to the to the Office of Management and Budget, the COVID-19 PHE will end May 11, 2023.) Recertifications (renewals) will be completed over the next 12 months, as beneficiaries are up for renewal. Recertification could result in termination or reduction of benefits.

If you are no longer eligible to receive Medicaid benefits, you can enroll in a health plan through the Affordable Care Act’s Health Insurance Marketplace®. Choosing a plan can feel overwhelming but having coverage protects you from very high, unexpected medical costs.

That’s why Atrium Health is proud to work with the most affordable¹ Health Insurance Marketplace plans – like Aetna CVS Health™ and Ambetter of North Carolina Inc. – to provide quality coverage with access to a level of care you won’t find anywhere else.

Take time to compare your options and make sure to choose a plan that includes Atrium Health doctors and hospitals.

Visit Healthcare.gov

Learn more

¹Based on 2023 Silver/bronze, age 50 rating, regions 4 and 5.

There are three ways to apply:

• Online: Apply online at ePass.
• Mail: Mail a paper application or drop it off at your local Department of Social Services (DSS). Get a copy of the paper application.
• In person: Apply in person at your local DSS. 

Call your local DSS if you cannot apply one of these ways. See a list of local DSS locations.

Learn more about how to apply for NC Medicaid.

ePASS is a way to apply for benefits and services, view case details and renew your Medicaid in North Carolina. New applicants and existing beneficiaries can create an account.

• A recent move or change of address
• If you are pregnant or your household size has changed
• A new job or a change in income

If there have been no changes to your personal information, no action is needed. 

Find your local DSS office 

Most people can change their health plan within 90 days of health plan enrollment.

When you enroll in a health plan, you can change your health plan for any reason within 90 days. After that, you can change your health plan:

• At your Medicaid recertification date
• If you are required to change health plans
• If you have a special or “with cause” reason, such as:
  • You moved out of your health plan’s service area
  • You have a family member in a different health plan
  • You cannot get all the related services you need from providers in your health plan, and there is a risk to getting the services separately
  • A different health plan may be better for your complex medical conditions
  • Your Long-Term Services and Supports (LTSS) provider is not in your health plan
  • Your health plan does not cover a service you need for moral or religious reasons
  • Other reasons (poor quality of care, lack of access to covered services, lack of access to providers experienced in dealing with your health care needs)

If you want to change your health plan outside of the 90 days, you can request to change your health plan in one of the following ways:

• Online with your NC Medicaid Managed Care account and submit the form. You will need to have your NCID ready to log in and request to change your health plan. Learn about submitting forms online.
• Call us toll-free at 833-870-5500 (TTY: 711 or RelayNC.com).
• Mail or fax the Health Plan Change Request form.

NC Medicaid will send you a letter telling you when you can choose a new health plan without a special reason. To learn more, call at 833-870-5500 (TTY: 711 or RelayNC.com) or use the NC Medicaid chat tool to chat online.

Some people can change their health plan at any time.

You can change your health plan at any time for these reasons:

• You need services to address a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI)
• You are a federally recognized tribal member or qualify for services through Indian Health Service (IHS)

To change your primary care provider (PCP) within your current health plan’s provider network, please contact your health plan. Below are the health plans and their contact information.

• AmeriHealth Caritas NC – 855-375-8811
• Carolina Complete Health – 833-552-3876
• HealthyBlue – 844-594-5070
• NC Direct Medicaid – 833-870-5588
• UnitedHealthcare Community Plan – 800-349-1855
• WellCare – 866-799-5318