March 23, 2021

Medicaid Transformation Begins as Open Enrollment Goes Live

Moving to Medicaid managed care has been a roller coaster ride in North Carolina.  There have been budget impasses, postponements and lawsuits.  All of those challenges seem to have been overcome.  The money has been appropriated to get started.  Standard Plan members are currently in an open enrollment period to choose their Prepaid Health Plans and primary care offices.  And the date of July 1 for go-live of the Standard Plan and Tribal Option is fast approaching. 

DHHS has sent out enrollment packets to Medicaid beneficiaries eligible for the Standard Plan and open enrollment began on March 15th.  The Medicaid Enrollment Broker is again available through the call center and mobile app to assist individuals and families in decision making.  The NC Medicaid Enrollment Call Center number is 833-870-5500/TTY: 833-870-5588. The free mobile app, called NC Medicaid Managed Care, is available for free on Google Play or the App Store.  This is a critical time for Standard Plan beneficiaries to choose their own primary care practice and Prepaid Health Plan.  The open enrollment period continues from March 15th through May 14th.  On May 15th, NC DHHS will use an algorithm to place Standard Plan beneficiaries with Prepaid Health Plans and primary care practices.  If a beneficiary receives a packet indicating he/she will be in the Standard Plan and that individual believes he/she should remain with the LME/MCO (later to be the BH/IDD Tailored Plan), there are forms available to apply for a further review. 

Providers also have resources for assistance.  DHHS has a NC Medicaid Help Center and a webpage