Fact Sheets
Department Fact Sheets
Standard Plans
- Introduction to Standard Plan – Fact Sheet - April 1, 2026
- Quick Reference Guide for Standard Plans - April 2, 2026
Tribal Option
Tailored Plans
- Tailored Plan Enrollment and Timelines - June 24, 2024
- Tailored Care Management - May 22, 2024
- What Providers Need to Know Before Tailored Plan Launch - Feb. 28, 2024
- What Providers Need to Know After Tailored Plan Launch - June 27, 2024
Children and Families Specialty Plan
Standard Plans and Tribal Option
- Contracting with Health Plans - Jan. 4, 2021
Tailored Plans
- Contracting with Tailored Plans - June 16, 2025
- Tailored Plan Provider Contracting Deadlines Questions and Answers - Feb. 28, 2024
For more information, visit the Provider Contracting with Health Plans page.
County Jails Suspension Policy
- Medicaid Policy for County Jails Fact Sheet - Sept. 9, 2025
Move to Tailored Plan
Standard Plans
- What is Auto-Enrollment and How Does it Work? - May 25, 2021 - English | Spanish
- Managed Care Populations (Do I Need to Choose a Health Plan?) - April 29, 2021 - English | Spanish
- Member Enrollment Part 1 - Health Plan Auto-Enrollment - Oct. 4, 2021
- Member Enrollment: Part 2 - Primary Care Provider (PCP)/Advanced Medical Home (AMH) Auto-Assignment - Oct. 4, 2021
- Auto Enrollment Scenarios Presentation - Dec. 30, 2020
Tailored Plans
- Tailored Plan Member Enrollment: PCP Auto-assignment - May 16, 2024
- Tailored Plan Auto-Enrollment & Opt-In Scenarios - April 19, 2024
Primary Care Provider/Advanced Medical Home Auto-Assignment Guidance
Retroactive Enrollment
Enrollment Broker Information
- NC Medicaid Provider and Health Plan Lookup Tool - Feb. 28, 2024
- For more information on the NC Medicaid Enrollment Broker notices and beneficiary materials, visit the Beneficiary Materials page.
Non-Emergency Medical Transportation (NEMT)
For facts sheets regarding Non-Emergency Medical Transportation (NEMT), please see the NEMT page on the County Playbook
NC Medicaid Programs and Services
- Medicaid Services for Justice-Involved Youth Per Section 5121 of the 2023 Consolidated Appropriations Act - March 24, 2025
- Processes and Frequently Asked Questions for 1915(i) Services - Jan. 13, 2025
- Tailored Care Management NC Medicaid Direct / Managed Care Enrollee Report - July 25, 2024
- Tailored Plan Managed Care Claims and Prior Authorizations Submission:
Frequently Asked Questions – Part 2 - May 30, 2024 - LME/MCO Consolidation Overview and FAQs – For Providers - January 2024
- What Providers need to know about Medicaid Expansion - Sept. 19, 2023
- NCCARE360-Healthy Opportunities (HOP) talking points - Sept. 5, 2023
- Enrollee Report Updates for Primary Care Practices in Advance of Tailored Plan Launch - June 24, 2024
- Home and Community Based Service Monitoring Tool Training - June 16, 2023
- Managed Care Claims Submission: What Providers Need to Know – Part 1 - June 27, 2024
- Provider Payment and Reimbursement - Nov. 18, 2025
- NC Health Choice Move to Medicaid - Feb. 28, 2024
- NC Health Choice Move to Medicaid Questions and Answers Fact Sheet - March 21, 2023
- NC Medicaid Managed Care: Provider Training - Feb. 28, 2024
- Advanced Medical Home - Nov. 14, 2022
- Transition of Care - March 15, 2024
- Nursing Facility - Health Plan Process - Oct. 17, 2022
- Nursing Facility Placement - Oct. 17, 2022
- Provider Postpartum - March 21, 2022
- What Providers Need to Know About Pharmacy - March 15, 2024
- Managed Care Claims and Prior Authorization Submission: Frequently Asked Questions - Part 2 - May 14, 2024
- Panel Management - July 30, 2024
- Prompt Payment - Dec. 18, 2024
- Managed Care PCP/AMH Provider Payment Matrix - June 14, 2021
- Health Equity Enhanced Payment Initiative - March 31, 2021
- Overview of Provider Directory Data Flow - Sept. 27, 2022
- Managed Care Eligibility for Newborns: What Providers Need to Know - Jan. 9, 2023
- Protections for Pregnant Women and Newborns - Dec. 19, 2022
- Telehealth Program - March 14, 2025
- Transitioning 1915(b)(3) Services to 1915(i) Authority: Service Providers - April 2023
- Transitioning1915(b)(3) Services to 1915(i) Authority: Tailored Care Management Providers - April 2023
- 1915(i) Tailored Care Manager Assessment Training - May 2023
- North Carolina’s Transition of 1915(b)(3) Benefits to 1915(i) - March 15, 2024
- Credentialing Committee - March 25, 2025
Visit the Provider Data Management and Credentialing Verification Organization page for information on a new solution to align North Carolina’s credentialing process with the National Committee for Quality Assurance Standards.
AHEC Guides
AHEC Practice Support
For more information on AHEC practice support including the Back Porch Series, visit the AHEC Practice Support page.
Health Plan Resources
Additional Resources
- For additional health plan resources and contact information, visit the Health Plan Contacts and Resources page.
- For additional health plan training opportunities, visit the Provider Playbook: Training Courses page.
Children and Families Specialty Plan
Provider Quick Reference Guide for the Children and Families Specialty Plan
Health Plan Quick Reference Guides
Standard Plans:
Provider Quick Reference Guide for Standard Plans
AmeriHealth Caritas North Carolina
amerihealthcaritasnc.com/provider/forms/index.aspx
Carolina Complete Health
network.carolinacompletehealth.com/resources/manuals-and-forms.html
Healthy Blue (Blue Cross Blue Shield)
provider.healthybluenc.com/north-carolina-provider/manuals-and-guides
United Healthcare Community Plan of North Carolina
uhcprovider.com/en/health-plans-by-state/north-carolina-health-plans/nc-comm-plan-home/nc-cp-training.html
WellCare of North Carolina
wellcarenc.com/
Tailored Plans:
Provider Quick Reference Guide for Tailored Plans
Alliance Health
alliancehealthplan.org/providers/network/provider-quick-reference-guide/
Partners
partnersbhm.org/wp-content/uploads/partners-health-management-quick-reference-guide.pdf
Vaya
providers.vayahealth.com/resources/vaya-quick-reference-guide/
This page was last modified on 10/01/2026