Beneficiary Notices

This page contains sample notices that will be sent to beneficiaries during the transition to Managed Care. Please click the “+” to expand the list for each section.

Enrollment Packet Reminder Notices

Reminder Notices

English Spanish
Reminder Notice Reminder Notice

 

Confirmation Notices

Confirmation Notices

English Spanish
Mandatory – Health Plan Confirmation Notice Mandatory – Health Plan Confirmation Notice
Exempt – NC Medicaid Direct Confirmation Notice Exempt – NC Medicaid Direct Confirmation Notice
Exempt – Health Plan Confirmation Notice Exempt – Health Plan Confirmation Notice
Exempt – Newly Exempt Confirmation Notice Exempt – Newly Exempt Confirmation Notice
Excluded – Newly Excluded Confirmation Notice Excluded – Newly Excluded Confirmation Notice
Tribal-Exempt – EBCI Tribal Option Confirmation Notice Tribal-Exempt – EBCI Tribal Option Confirmation Notice
Tribal-Exempt – Health Plan Confirmation Notice Tribal-Exempt – Health Plan Confirmation Notice
Tribal-Exempt – NC Medicaid Direct Confirmation Notice Tribal-Exempt – NC Medicaid Direct Confirmation Notice
Tribal-Excluded – EBCI Tribal Option Confirmation Notice Tribal-Excluded – EBCI Tribal Option Confirmation Notice
Tribal-Excluded – NC Medicaid Direct Confirmation Notice Tribal-Excluded – NC Medicaid Direct Confirmation Notice

 

Appeals and Grievances