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Medicaid Managed Care Questions and Answers for Beneficiaries

For now, Medicaid will not move to new health plans. As a Medicaid beneficiary, you keep getting Medicaid care and services the way you do now. Your primary care provider (PCP) stays the same. You do not need to choose a Medicaid Managed Care health plan at this time.  

When will Managed Care restart? When will my health plan start?
For now, the move to new health plans is on hold. We will tell you when it restarts and when you will be able to choose a health plan.

Does this change my Medicaid coverage?
No. Your coverage will stay the same. You will keep getting your Medicaid care and services the way you do now. Your primary care provider (PCP) stays the same. 

Do I need to do anything right now? Do I need to still choose a health plan? 
No. You do not need to do anything right now. You do not need to choose a health plan. You will keep getting your Medicaid care and services from the State the way you do now. 

Can I still see my doctor?
Yes. You can go to your same primary care provider (PCP) and specialists you see today. Your PCP is listed on your Medicaid card. If you have any questions, call the Medicaid Contact Center at 1-888-245-0179.

Who do I go to for Behavioral Health Intellectual/Developmental Disability (I/DD) benefits? Should I still go to my Local Management Entities - Managed Care Organizations (LME-MCOs)?
Yes. If you are currently receiving services from an LME-MCO, you will continue to get those services.

What if my Medicaid coverage is set to end before Managed Care restarts?
If your coverage is set to end before Managed Care restarts, your Medicaid coverage will go through the same yearly eligibility review and recertification process used today.

What if I already chose a health plan?
We will save your health plan choice. When Medicaid health plans restart, you will have an opportunity to change your health plan if you choose.

Do I still need to enroll in a health plan while Managed Care is on hold? Can I still choose a health plan?
No. You cannot choose a health plan or PCP for a health plan now. The State will tell you when Managed Care restarts. You will be asked to choose a health plan then. 

Why was Managed Care delayed? Why did this happen?
Due to ongoing state budget issues, Medicaid health plans cannot start at this time.

Will Managed Care ever restart/happen?
For now, the move to new health plans is on hold. We will tell you when it restarts and when you will be able to choose a health plan.

What is the status of the form I submitted (Raise Your Hand)?
For now, no form is needed.  The forms submitted are not being reviewed during the Medicaid Managed Care suspension. If you currently receive services from LME-MCOs, you will continue to get service from them. If you have NC Medicaid and there are behavioral health services that you need, talk to your LME-MCO. If you have NC Health Choice, are calling for a child that is age three or younger, or are a legal non-citizen, contact Beacon Health at 1-888-510-1150.

Where should I check for updates on what is happening with Medicaid and Managed Care?
Visit medicaid.ncdhhs.gov for the latest information. We will tell you when the move to health plans restarts and when you will be able to choose a health plan.

How does this annoucement affect the rollout of Managed Care benefits to the Tribal population?
At this time, the Department is planning to introduce the Eastern Band of Cherokee Indians (EBCI) Tribal Option beginning in July 2021.

Will the same plan options be available in the future? 
The Department expects the same plan options will be available in the future. The Department will let beneficiaries know if there are any changes to their health plan options.