On May 26, 2021, The North Carolina Department of Health and Human Services (NCDHHS) announced that all Medicaid beneficiaries currently eligible to transition to managed care have selected or been assigned a health plan with 97% enrolled in a plan that includes their current primary care provider (PCP) in network.
As a result, nearly all current beneficiaries will keep the same health care provider that they have today when managed care launches on July 1. That means more families can continue to visit the practices and doctors who know them best and are familiar with their specific health care needs.
What happened if patients didn’t enroll?
Beneficiaries who did not select a health plan during open enrollment, which ended on May 21, were auto-enrolled in a plan. NCDHHS’ auto-enrollment process prioritized existing relationships between beneficiaries and their primary care provider and, where possible, a plan that has contracted with that provider was selected for the beneficiary. Confirmation notices and health plan welcome packets will be mailed to beneficiaries through June 12.
A summary of NC Medicaid Managed Care enrollment by plans and regions can be found here.
How do patients make changes?
Whether beneficiaries chose a plan during open enrollment or were auto-enrolled by NC Medicaid, everyone will have through Sept. 30, 2021, to change their health plan or primary care provider for any reason by contacting the NC Medicaid Enrollment Broker. After that, unless there is a special reason, beneficiaries must wait until their next Medicaid recertification date to change health plans.
What if patients have questions?
More information can be found on the “Do I Need to Choose a Health Plan?” fact sheetOpen PDF. Beneficiaries are encouraged to visit the NC Medicaid Enrollment Broker website at ncmedicaidplans.gov or call the Enrollment Broker at 833-870-5500 (TTY: 833-870-5588) with any additional questions.
For more information, please see the press release here.