Who must choose a health plan?
Most people in NC Medicaid must choose a health plan in the NC Medicaid Managed Care program. Some people can choose to stay in NC Medicaid Direct. They will not need to choose a health plan. NC Medicaid Managed Care will send you a letter that tells you if you must enroll. To find out now, call us at 1-833-870-5500 (TTY: 1-833-870-5588). The call is toll free. Or use the chat tool to chat with us online. To learn more about NC Medicaid Managed Care, go to Get answers.
Even if you already chose a health plan, you will need to choose again. If you don’t choose a health plan, we will choose one for you. You know your needs best, so it’s better if you choose.
Who has the option to choose a health plan?
You have the option to choose a health plan if you:
- Are a federally-recognized tribal member or qualify for Indian Health Services (IHS) and live in Cherokee, Haywood, Graham, Jackson or Swain County or in a neighboring county of the 5-county region. You may choose to enroll in the Eastern Band of Cherokee Indians (EBCI) Tribal Option. As a member of the EBCI Tribal Option, you can still get services from any Medicaid or NC Health Choice provider.
- Need certain services to address needs related to developmental disability, behavioral health, traumatic brain injury or substance use disorder.
For questions, call 1-888-245-0179. To learn more about NC Medicaid Direct, go to Get answers.
Who cannot choose a health plan?
Some people will not need to choose a health plan because of the type of health services they need. They will stay enrolled in NC Medicaid Direct. For example, individuals who get Innovations Waiver services, Traumatic Brain Injury (TBI) Waiver services, or Community Alternatives Program for Children (CAP/C) or Community Alternative Program for Disabled Adults (CAP/DA) services will stay enrolled in NC Medicaid Direct. If you qualify, you can choose the EBCI Tribal Option and keep getting waiver services.
To learn more, call us at 1-833-870-5500 (TTY: 1-833-870-5588). The call is toll free. Or use the chat tool to chat with us online.