Johnston, Nash, Wake, Wilson Counties Included
Open enrollment for Medicaid managed care is underway in 27 counties. From July 15 through Sept. 13, 2019, more than 300,000 households with nearly 540,000 people in Medicaid can choose a health plan to provide their Medicaid services, along with a primary care provider.
Enrollment packets were mailed recently in Alamance, Alleghany, Ashe, Caswell, Chatham, Durham, Davidson, Davie, Forsyth, Franklin, Granville, Guilford, Johnston, Nash, Orange, Person, Randolph, Rockingham, Stokes, Surry, Vance, Wake, Warren, Watauga, Wilkes, Wilson and Yadkin counties. Packets include a letter, enrollment form, information sheet, comparison chart and postage-paid business reply envelope. Coverage for these beneficiaries under managed care will begin Nov. 1, 2019.
Several tools are available to help people choose and enroll in a health plan. The Medicaid Managed Care Call Center (833-870-5500) and website went live in late June. There is also a NC Medicaid Managed Care mobile app available on Google Play and the App Store.
All health plans are required to have the same Medicaid services, such as office visits, blood tests and X-rays. Health plans also have added services such as gym memberships and programs to have a healthy pregnancy. Health plans work with different doctors and health care professionals. Each plan has its own network of qualified doctors and health care professionals. Earlier this year, the Department awarded contracts to five health plans.
In 2015, the NC General Assembly enacted legislation directing the Department of Health and Human Services to transition Medicaid and NC Health Choice from fee-for-service to managed care. Under managed care, the State contracts with insurance companies, which are paid a predetermined set rate per person to provide all services. Transforming North Carolina’s Medicaid program to managed care is the most significant change made since its inception.
“Our vision for Medicaid managed care is to improve health and well-being through an innovative, whole-person centered and well-coordinated system of care that addresses both medical and non-medical drivers of health,” said DHHS Secretary Mandy Cohen, M.D. “We have reached this milestone through strong collaboration among the State and its community and legislative partners.”
Open enrollment for individuals in the remaining counties across the state is scheduled to begin on Oct. 14, 2019.
To help address questions and respond to issues, the Department has a dedicated call center and webpages with more information.
Beneficiaries can call the Medicaid Managed Care Call Center at (833) 870-5500 or visit ncmedicaidplans.gov.
For general questions about the transformation to managed care, email Medicaid.Transformation@dhhs.nc.gov.
-NCDHHS News Release