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Medicaid

Notice about NC Medicaid Managed Care

With Medicaid Managed Care suspended, NC Medicaid will continue to operate under the current fee-for-service model administered by the Department. The Department will not decide on a new go-live date until it has program authority within a budget that protects the health and safety of North Carolinians and supports the Department's ability to provide critical oversight and accountability of Medicaid Managed Care.

  • Beneficiaries: Continue using Medicaid services as you do today. You do not need to enroll in a health plan at this time. Look for a notice to arrive in the mail with details. Call the Medicaid Contact Center at 888-245-0179 if you have questions about Medicaid Managed Care.

         Medicaid Managed Care Questions & Answers for Beneficiaries

  • Providers: Auto-assignment has been suspended; however, you should continue to contract with health plans. Call the Medicaid Contact Center at 888-245-0179 if you have questions about Medicaid Managed Care.
  • Procurement: Procurement efforts currently underway are expected to continue. There may be changes in the timing or schedule.

Background

In 2015, the NC General Assembly enacted legislation directing the Department to transition North Carolina Medicaid and NC Health Choice from fee-for-service to managed care. Under managed care, the state contracts with insurance companies, which are paid a predetermined set rate per person to provide all services. The Department was on track to launch managed care Feb. 1, 2020. New funding and program authority were required from the General Assembly to meet this timeline. The General Assembly adjourned in November 2019 without providing new spending and program authority required for the transition to managed care.

Our Mission and Vision

The mission of NC Medicaid is to use resources and partnerships to improve health care for all North Carolinians. The Medicaid vision is to lead the transformation to a healthier North Carolina.

DHHS and Medicaid are devoted to quality customer service. We welcome your input and suggestions to how we can improve.