Medicaid is changing in NC!

Starting July 1, 2021, Medicaid services will be available through Prepaid Health Plans (PHPs). A PHP is a group of doctors, hospitals and other providers that work together to provide all types of health care. This includes – physical health, behavioral health, and medications. Effective July 1, 2021, EVERY NC Medicaid recipient must choose a PHP or one will be chosen for you by NC Medicaid.  WE WANT TO HELP YOU THROUGH THIS PROCESS!

1-      Choose a primary care provider (PCP)

• Your PCP is ABC PEDIATRICS 

2-      Choose a health plan

• ABC PEDIATRICS works with all available health plans.
• Attached to this notice is a list of your available plans. The list tells you about the health plans and the various services they offer. Choose the best one for your family.

3-      Enroll in one of these ways

• Go to ncmedicaidplans.gov
• Use the NC Medicaid Managed Care mobile app. To get the free app, search for NC Medicaid Managed Care on Google Play or the App Store.
• Call NC Medicaid at 1-833-870-5500 (TTY: 1-833-870-5588).
• Mail the enrollment form using the return envelope that came in your package.  Or fax it to 1-833-898-                    9655.
• Choose your health plan by May 14, 2021 or one will be chosen for you. It is better if you choose a health plan, because you know your health care needs best.

After a PHP is selected, information and a new ID card will be mailed. The ID card should be used for health care services beginning on July 1, 2021. Questions can be answered by your health plan’s member services number on the ID card.

If you decide later that you want to change your health plan:

Health plans can be changed until September 30, 2021. After that, unless there is a special reason, health plans cannot be changed until the Medicaid recertification date. Those who feel they should not be enrolled in a health plan because they need certain services to address a developmental disability, behavioral health, traumatic brain injury or substance use disorder, reconsideration can be requested. This is a review of the decision. To request a reconsideration, call 1-833-870-5500 (TTY: 1-833-870-5588).

Questions? Go to ncmedicaidplans.gov. You can also use the “chat” tool on the website. Or call 1-833-870-5500 (TTY: 1-833-870-5588), 7 a.m. to 8 p.m., 7 days a week.  After May 14, 2021, hours are open from 7 a.m. to 5 p.m., Monday through Saturday.

Attached is a SAMPLE enrollment package. Some of the areas are filled in as an example to help you complete your form.  

Please call a member of our BUSINESS OFFICE STAFF if you need any help:   (910) 892-1333, then press 4.