NC Medicaid Managed Care Open Enrollment

NC Medicaid Managed Care Open Enrollment Mar 15-May 14, 2021 FAQ's

North Carolina is changing the way it offers health insurance coverage for most people eligible for Medicaid. Beginning July 1, 2021, most Medicaid beneficiaries will receive their health benefits through a health plan instead of directly from North Carolina.

If you are eligible, you may choose from several health care plans during open enrollment, which runs from March 15 – May 14, 2021.

How to keep your Duke doctor in your health care plan

To continue to receive your health care from Duke, you must choose a Duke primary care provider and enroll in one of the health plans that includes Duke. Choosing a plan during this time period will ensure your care is not interrupted on July 1 when the new Medicaid change takes effect. You can review the plans in which Duke participates at PlanforDuke.org.

Which health plans will include Duke? Duke Health is participating in AmeriHealth Caritas of North Carolina, Healthy Blue and WellCare of North Carolina. Refer to PlanForDuke.org for the latest information.

Do I have to change my plan to keep getting behavioral health, intellectual and developmental disability, or traumatic brain injury services? If you are currently enrolled in NC Medicaid Direct, please call 1-888-245-0179 to learn about your options. You may be able to get services from a Local Management Entity / Managed Care Organization (LME-MCO). If you enroll in a health plan through NC Medicaid Managed Care, you may not be able to get certain NC Medicaid Direct Services.


When is open enrollment for NC Medicaid?

Open enrollment is March 15-May 14, 2021. The new plans begin July 1, 2021.

Does this change apply to everyone on Medicaid?
This change will not apply to everyone who is eligible for Medicaid. North Carolina will let you know if you will remain with traditional Medicaid, known as NC Medicaid Direct, or are eligible for the new plans. Please call North Carolina Medicaid at 1-833-870-5500 if you have questions.

What happens if I don't choose a plan by May 14, 2021? 

If you do not select a plan by May 14, you will automatically be enrolled in a health plan. If Duke is not participating in the plan you are automatically enrolled in, you will have 90 days after July 1 to change your plan.


Can I continue to see my Duke doctor through July 1, 2021? 

Yes. You will have access to Duke doctors and facilities now through July 1, 2021. To ensure you can continue to access Duke after July 1, 2021, choose one of the health plans that include Duke.


I have questions. Is there someone I can speak with? 

For more information, visit NCMedicaidPlans.gov or call 1-833-870-5500 to speak with an independent representative. You can also contact 1-888-275-3853.

We recognize these restrictions may be difficult for you and your loved ones. This is an unprecedented time, and the COVID-19 visitor policy is intended to provide additional safeguards for our patients, families, visitors and team members. Thank you for your understanding and support of our commitment to safety.






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