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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

1-833-870-5500 (TTY: 1-833-870-5588), 7am-5pm, Mon-Sat. 
The Enrollment Call Center’s website has a live chat feature to help you. 

NC Medicaid Ombudsman

Call 877-201-3750 or visit the NC Medicaid Ombudsman’s website.

Do I need to choose a health plan?

Learn more.

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. 

Additional Resources

Changes to Medicaid FAQ

NC Medicaid Ombudsman Resources, including a video about the program.

Information about Medicaid Health Care

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