NC Health Choice is moving to Medicaid
On April 1, 2023, beneficiaries currently receiving NC Health Choice coverage will move to Medicaid.
Currently, North Carolina has two programs that offer medical coverage for eligible children age 6 to 18 – Medicaid and NC Health Choice.
A provision included in the North Carolina state budget, approved in July 2022, directed the Department of Health and Human Services to move NC Health Choice beneficiaries from the NC Health Choice program to the Medicaid program.
What are the benefits of this change?
With NC Medicaid beneficiaries will:
• No longer have enrollment fees or copays
• Be eligible for Non-Emergency Medical Transportation (NEMT) for Medicaid-covered services
• Have pregnancy and 12-month postpartum coverage
• Be eligible for Early & Periodic Screening, Diagnosis and Treatment (EPSDT); a benefit designed to discover and treat health conditions before they become serious
Do beneficiaries need to do anything?
NC Health Choice beneficiaries do not have to take any action on their own for the change to take effect; they will be automatically transferred to NC Medicaid.
With the move to Medicaid, NC Health Choice beneficiaries will keep their Medicaid ID number (sometimes called recipient number) and should keep using their current ID card until they get their new Medicaid ID card in the mail.
Beneficiaries in the NC Health Choice program cannot opt out of moving to the Medicaid program. NC Health Choice will no longer be an offered program, beginning April 1, 2023.
What do providers need to do?
Providers enrolled in both NC Health Choice and NC Medicaid will not need to do anything.
Providers who are enrolled only in NC Health Choice will need to enroll in Medicaid to continue serving these beneficiaries.
Providers should continue to verify a beneficiary’s eligibility through NCTracks with their Medicaid ID number.
- NC Health Choice beneficiaries will be mailed letters with information on the move to Medicaid and the new benefits.
- NC Health Choice beneficiaries will be mailed a Medicaid ID card.
April 1, 2023
Medicaid coverage begins
- NC Health Choice Move to Medicaid Beneficiary Fact Sheet - Jan. 25, 2023 English I Spanish
- NC Health Choice Move to Medicaid Provider Fact Sheet - Jan. 31, 2023
- NC Health Choice Move to Medicaid: Timeline for Claims Adjudication and Process for Prior Approvals - Feb. 6, 2023
- NC Health Choice Move to Medicaid Questions and Answers fact sheet - March 28, 2023
NC Medicaid Contact Center
This page was last modified on 03/30/2023