Health Plans

DHHS to Launch Medicaid Managed Care July 1, 2021 

Until Managed Care goes live on July 1, 2021, Medicaid beneficiaries get care and Medicaid providers submit claims as they do today. 

NC Medicaid Managed Care Health Plans 

There are six health plan contracts, five prepaid health plans and one primary care case management entity, to deliver Medicaid services starting July 1, 2021, to eligible North Carolina beneficiaries. 

AmeriHealth Caritas of North Carolina – Prepaid Health Plan; Statewide
Blue Cross and Blue Shield of North Carolina – Prepaid Health Plan; Statewide
UnitedHealthcare of North Carolina – Prepaid Health Plan; Statewide
WellCare of North Carolina – Prepaid Health Plan, Statewide
Carolina Complete Health, Inc. – Prepaid Health Plan, Regions 3, 4 and 5 
Eastern Band of Cherokee Indians (EBCI) Tribal Option – Primary Care Case Management managed by the Cherokee Indian Hospital Authority. For federally recognized Tribal members and others eligible for services through the federal Indian Health Service agency. 

Health Plan Contracts 

The contract (i.e., Revised and Restated Request for Proposal (RFP)) reflects the original RFP issued Aug. 9, 2018, with all addenda and negotiation documents incorporated. 
Contract #30-190029 Prepaid Health Plan Services and Draft Rate Book
Contract #30-190029 Prepaid Health Plan Services Amendment 1

EBCI: Email medicaid.transformation@dhhs.nc.gov to request a copy of the contract.