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NC Medicaid Managed Care Open Enrollment Begins Statewide

Raleigh

Open enrollment for Medicaid Managed Care begins statewide today. Most people who receive Medicaid can choose a health plan and primary care provider to deliver their Medicaid services as part of the state’s transformation to managed care. Today’s announcement expands open enrollment from the initial 27 counties that launched mid-July to all 100 counties and an additional 860,000 people. Open enrollment ends for everyone on Dec. 13, 2019, and coverage is scheduled to begin Feb. 1, 2020.

Enrollment packets were mailed over the last two weeks to the remaining 73 counties in managed care regions 1, 3, 5 and 6. Packets include a letter, enrollment form, information sheet, comparison chart and postage-paid envelope. 

An enrollment website is available to help people learn more about their options, enroll in a health plan and select a primary care provider. There is also an NC Medicaid Managed Care mobile app available on Google Play and the App Store. Additionally, the Medicaid Managed Care Call Center (833-870-5500) is staffed with enrollment specialists who are independent from the health plans. These specialists can help people find the health plan that is best for them and their family. 

Earlier this year, the Department awarded contracts to five health plans. All health plans are required to have the same Medicaid services, such as office visits, blood tests and X-rays. Health plans also have added services such as gym memberships and healthy pregnancy programs. Each health plan has its own network of qualified doctors and health care professionals. 

In 2015, the NC General Assembly enacted legislation directing the Department of Health and Human Services to transition Medicaid and NC Health Choice from fee-for-service to managed care. Under managed care, the Department contracts with insurance companies, which are paid a predetermined set rate per person to provide all services. Transforming North Carolina’s Medicaid program to managed care is the most significant change made since its inception.

For questions about open enrollment, call the Medicaid Managed Care Call Center at (833) 870-5500 or visit ncmedicaidplans.gov. For general information about the transformation to managed care, email Medicaid.Transformation@dhhs.nc.gov

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