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NC Department of Health and Human Services
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Health Choice Providers

N.C. Health Choice for Children (NCHC) is a fee-for-service program providing free or low-cost health insurance for children and teens from age 6 through the month of their 19th birthday. The benefits covered by NCHC are the same as the benefits covered by the State Employees Health Plan Comprehensive Major Medical (CMM) health plan. Additional benefits for vision, dental, and hearing services are also covered and follow guidelines similar to Medicaid.

Providers submit medical claims to Blue Cross and Blue Shield of N.C. (BCBSNC) for processing. Any licensed health care provider in North Carolina can provide covered services appropriate to their specific licensure and specialization to NCHC recipients. It is not necessary for providers to enroll with BCBSNC to provide services and submit claims, but claims submitted by BCBSNC providers generally process for payment quicker than claims submitted by providers who are not enrolled with BCBSNC.

NCHC Contact Information

  • Customer Service
    General Information and Questions About Claims
    1-800-422-4658
    1-800-442-7028 (TTY line)
    919-765-7080 (fax)

    N.C. Health Choice
    Customer Service
    PO Box 30111
    Durham, NC 27702-3111
  • Prior Approval
    General Information and Questions About Prior Approval
    1-800-672-7897
    919-765-4890 (fax)

    N.C. Health Choice
    Member Health Partnerships Operations (MHPO)
    PO Box 30111
    Durham, NC 27702-3111
  • Inpatent Hospital Admission for Medical/Surgical Treatment
    To Get a Hospital Stay Approved
    1-800-672-7897
    919-765-4890 (fax)
  • Mental Health, Alcohol, and Drug Treatment
    General Information and Questions
    1-800-753-3224
    919-379-9035 (fax)

    Mental Health Case Manager
    PO Box 12438
    Research Triangle Park, NC 27709-0438
  • Children with Special Health Care Needs Help Line
    General Information and Questions About Available Services
    1-800-737-3028
  • Pharmacy Benefit Manager (Medco)
    Questions About Prescription Drug Benefits and Claims
    1-800-336-5933

    N.C. Health Choice
    Pharmacy Benefit Manager
    PO Box 30493
    Tampa, FL 22520-3493
  • Dental Prior Approval
    General Information and Questions About Prior Approval
    1-800-672-7897
    919-765-4890 (fax)

    N.C. Health Choice Dental Analyst
    PO Box 610
    Durham, NC 27702-0610
  • Provider Paper Claims (Except Prescription Drugs)
    N.C. Health Choice
    PO Box 30025
    Durham, NC 27702-3025
  • Appeals - Mental Health, Alcohol, and Drug Treatment
    N.C. Health Choice
    Appeals Coordinator
    PO Box 12438
    Research Triangle Park, NC 27709-2438

    For special delivery or overnight mail service:
    N.C. Health Choice
    Appeals Coordinator
    3800 Paramount Pkwy., Suite 300
    Morrisville, NC 27560

    919-379-9035 (fax)
  • Appeals - Medical and Pharmacy
    N.C. Health Choice
    Appeals and Grievance
    PO Box 3869
    Durham, NC 27702-3869

    919-765-2923 (fax)

Frequently Asked Questions

Provider Forms for NCHC Special Needs Services

Provider Bulletins - NCHC Information

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.