Medicaid Health Plans
Find out if you need to choose a health plan
Medicaid is moving from Medicaid Direct (the current system) to Managed Care. This transition is confusing because not everyone with Medicaid has to choose a health plan. The majority of people with Medicaid will have to choose a health plan (also called PHPs) or they will be auto-assigned to a plan.
However, some people with Medicaid aren’t allowed to choose a health plan (also called PHPs). Others have a choice to choose a plan or stay in Medicaid Direct. Use the form below to find out which group you are in.
NC Enrollment Call Center
NC Medicaid Ombudsman
Do I need to choose a health plan?
Important things to remember
If in doubt, call the Enrollment Call Center
- If you do not know where you should be, call the Enrollment Call Center at 1-833-870-5500. They can look you up by your Medicaid number and tell you whether or not you need to choose a plan.
- If you think you are in the wrong place, call the Enrollment Call Center, or fill out this form and choose “enrollee / beneficiary” to request to stay in Medicaid Direct.
- If you have questions or a problem, always start by calling the Enrollment Call Center. If they are unable to help you, call the Ombudsman at 877-201-3750.
There is no harm in choosing to stay where you are
- Finally, if you are given a choice to move to Managed Care or stay where you are, you can always opt out of choosing a plan. There is no harm in choosing to stay where you are. However, if you received a notice and do not choose a plan, you will be auto-assigned a plan. You will be able to change your plan until the end of September.
NC Medicaid Ombudsman Resources, including a video about the program.