What you need to know about Medicaid
Changes to Medicaid are coming in 2027. We can help you understand what to expect.
Tailored Plans
Tailored Plans are designed to provide specialized health and medical services for Medicaid members with specific needs.
Take steps now to help protect your coverage
Beginning in 2027, some Medicaid members may be asked to complete additional eligibility reviews, provide updated information or meet new requirements to keep their coverage. If any action is needed, your state Medicaid agency will contact you directly with instructions.
Expected changes include:
- New work and community engagement requirements for some adults ages 19-64, with exemptions for certain individuals, including those with disabilities or medical frailty. Understanding whether you qualify for an exemption can help you protect your coverage.
- More frequent eligibility reviews, with some Medicaid members required to verify eligibility every six months instead of annually.
- Additional documentation or verification requirements from state Medicaid agencies.
Some patients may lose Medicaid coverage if they miss renewal deadlines or do not respond to requests from their state.
Call 800-888-3081Learn more about Medicaid changes and coverage at:
What you can do now
These changes are expected to begin in 2027, so now is the time to stay informed, keep your information up to date, and know where to turn for help.
- Keep your contact information current Make sure Medicaid has your current mailing address, phone number and email address.
- With an enhanced ePASS account, you can update your address and other information for Medicaid online without having to call or visit your local Department of Social Services (DSS) office. Sign up for an ePass account.
- Watch for important notices Pay attention to mail, email, text messages, and other communications from Medicaid.
- Respond quickly If your state Medicaid agency asks for information or documentation, respond as soon as possible to avoid delays or interruptions in coverage.
- Ask for help if needed If you have questions about your Medicaid coverage or need help understanding next steps, resources are available to assist you.
To find out if you are eligible or to apply, visit Medicaid.NC.gov.
What if I no longer qualify for Medicaid?
If you’re no longer eligible to receive Medicaid coverage, you can select a health plan through the Affordable Care Act’s Health Insurance Marketplace. Learn more about the Marketplace at healthcare.gov.
These are the health insurance plans offered through the health care marketplace that include Atrium Health:
- Ambetter of North Carolina (with Atrium Health)
- Blue Advantage PPO
- Blue Care HMO
- Blue Local (with Atrium Health)
- Blue Value (Columbus Regional Healthcare System ONLY)
- Oscar Health (with Atrium Health)
- UnitedHealthcare
See Atrium Health's Marketplace resources
Our financial advocates can help
If you have questions about Medicaid changes, call 800-888-3081.
If you have questions about Marketplace enrollment, our certified application counselors can help. Please call 866-988-0520.
How do I apply for Medicaid?
You have flexible options when applying for Medicaid. Choose the method that works best for you.
Online
Visit ePass and log in or create an account to apply.
By phone
Call your county’s Department of Social Services (DSS). Find your local agency online or by calling the NC Medicaid Contact Center at 888-245-0179.
By fax, mail or dropoff
Fill out a paper application and send it to or drop it off at your local DSS agency. 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.
Learn more about how to apply for NC Medicaid.
Need more help?
Contact your state Medicaid agency to update your information or learn more about your coverage requirements. Learn more at Medicaid.gov.
Frequently asked questions about Medicaid renewals
Atrium Health doctors and hospitals in the Charlotte metro area are in all NC Medicaid health insurance plans:
- Alliance Health
- AmeriHealth Caritas NC
- Carolina Complete Health
- HealthyBlue
- NC Direct Medicaid
- Trillium Health Resources
- UnitedHealthcare Community Plan
- Vaya Health
Important: If you have a medical emergency, go to the closest hospital emergency room. Atrium Health hospitals provide services to all patients seeking treatment for an emergency medical condition, regardless of what health insurance plan you have or if you can pay for emergency services.
Medicaid covers mandatory benefits plus additional health services North Carolina has added for eligible beneficiaries. Benefits may be different depending on age, income and health care needs. In general, Medicaid may cover the following services:
- Doctor visits, including OB/GYNs, health departments and rural health clinics
- Emergency care
- Lab tests and X-rays
- Hospital/surgical center services, including anesthesia
- Prescriptions
- Vision and hearing
- Dental services
- Mental and behavioral health
- Medical equipment, such as wheelchairs
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.
- If you move or change your address
- If you are pregnant or your household size has changed
- If you have a new job or change in income
If there have been no changes to your personal information, you don’t need to do anything.
When you enroll in a health plan, you can change your health plan once for any reason within 90 days of initial enrollment. After that, you can change your health plan:
- At your Medicaid renewal date
- If you’re 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.
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).
Learn more about making changes to your health plan:
- Online at ePASS – Log in and review your Medicaid managed care enrollment options.
- Phone – Call the NC Medicaid Contact Center at 888-245-0179 and ask about changing your health plan.
To change your primary care provider within your current health plan’s provider network, please contact your health plan.