This bulletin is an update to the previously published NC Medicaid Temporary Flexibilities Due to Expected January Winter Storm bulletin.
North Carolina Governor Josh Stein issued Executive Order No. 31 on Jan. 21, 2026, declaring a State of Emergency in anticipation of the severe winter storm that impacted the state on Jan. 24, 2026. The storm is continuing to cause significant impacts across North Carolina.
NC Medicaid is committed to North Carolina's response to this storm. We are working with county and federal partners to make it faster and easier for beneficiaries to receive — and for health care professionals to provide — Medicaid care and services.
NC Medicaid has extended the Winter Storm State of Emergency Medicaid flexibility through Jan. 30, 2026, previously effective through Jan. 26, 2026.
This bulletin describes the updated flexibility now effective Jan. 23, 2026, to Jan. 30, 2026, unless otherwise communicated by the North Carolina Department of Health and Human Services (NCDHHS), for the NC Medicaid program, including NC Medicaid Direct and NC Medicaid Managed Care, as indicated below. Updates will be provided as they become available.
Flexibility for both NC Medicaid Direct and NC Medicaid Managed Care
Early Prescription Refills during Governor’s State of Emergency Declaration
Severe weather conditions may present situations where NC Medicaid beneficiaries in impacted areas may require an early refill of their medications. NC Medicaid enrolled pharmacy providers have been approved to fill these prescriptions early, following applicable co-pay requirements.
Effective Jan. 23, 2026, to Jan. 30, 2026 (unless otherwise communicated by NCDHHS), the early refill is being allowed to ensure that all Medicaid beneficiaries have access to necessary medications.
For NC Medicaid Direct
NC Medicaid enrolled pharmacy providers should resubmit these claims with “09” (Emergency Preparedness) in the Prior Authorization (PA) Type Code field to override a denial for an early refill. Do not place any values in the Submission Clarification Code field. This allows the beneficiaries to receive their medication during an emergency without using either of their limited-use Submission Clarification Code overrides. Additional questions can be directed to the NCTracks service line (800-688-6696).
For NC Medicaid Managed Care
Providers should contact the pharmacy service line (numbers below) to confirm if additional documentation or processes need to be completed to allow for emergency prescription refills during this State of Emergency.
Standard Plans
- AmeriHealth: 866-885-1406
- Healthy Blue: 833-434-1212
- Carolina Complete: 833-750-4461
- United Healthcare: 855-258-1593
- Wellcare: 866-799-5318
Tailored Plans
- Alliance Health: 855-759-9300
- Partners: 866-453-7196
- Trillium: 866-245-4954
- Vaya Health: 800-540-6083
Children and Families Specialty Plan
- Healthy Blue Care Together: 833-777-3788