DHHS has announced the launch of NC Medicaid’s managed care enrollment website, www.ncmedicaidplans.gov, in preparation for the launch of Medicaid Managed Care scheduled on July 1, 2021. Medicaid Managed Care open enrollment will begin March 15, 2021 and will continue through May 14, 2021.
The purpose of the enrollment website is to help Medicaid beneficiaries learn more about Medicaid Managed Care. In 2015, the NC General Assembly enacted legislation directing NCDHHS to transition Medicaid and NC Health Choice from a primarily fee-for-service delivery system to managed care. Under managed care, the state contracts with insurance companies, which are paid a predetermined set rate per enrolled person to provide all services.
The enrollment website provides information about who will have to choose a health plan, who will stay in the traditional Medicaid program (NC Medicaid Direct) and who can choose between the two. It will also share the basic medical and behavioral health benefits that are offered. There will be a list of frequently asked questions and answers to help beneficiaries understand the changes.
Most people currently receiving Medicaid benefits will need to enroll in Medicaid Managed Care. Medicaid beneficiaries will be able to choose from five health plans — WellCare, United HealthCare, Healthy Blue, AmeriHealth Caritas and Carolina Complete Health (serving regions 3, 4 and 5). Those who are federally recognized tribal members or qualify for Indian Health Services are exempt from managed care. Those who live in Cherokee, Graham, Haywood, Jackson or Swain counties or in a neighboring county may choose to enroll in the Eastern Band of Cherokee Indians (EBCI) Tribal Option.
A small number of people will not need to choose a Medicaid Managed Care health plan because of the type of health services they need. They will stay enrolled in NC Medicaid Direct. To learn more, providers and beneficiaries can visit the NC Medicaid Direct services page on the enrollment website.
Features that will be added to the Medicaid Managed Care enrollment website in January 2021 include:
A Medicaid and NC Health Choice Provider and Health Plan Lookup Tool members can use to find and select the best primary care provider for their families.
A Choice Guide members can use to view health plans and select those with the best features for their needs.
To learn more about North Carolina’s transformation to Medicaid Managed Care, visit the Medicaid Transformation webpage.
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NCTracks Contact Center: (800) 688-6696