Medicaid Managed Care
Attend our FREE Medicaid Managed Care Clinic to learn about NC Medicaid's transformation to managed care. On July 1, 2021, approximately 1.6 million North Carolinians who receive Medicaid benefits were enrolled into Prepaid Health Plans (PHPs) due to NC Medicaid’s transformation from fee-for-service to managed care. We will be discussing these recent changes, how they may impact you, your rights, and how to get the information and help that you need. At the clinic, you will view a live presentation. An attorney from Legal Aid of North Carolina’s Medicaid Appeals Technical Team project will be available to answer general questions. Sign up for the clinic using the form below.
The clinic will provide you with general legal information and guidance only. The clinic will not provide you with specific, individual legal advice. If you need more help after the clinic, call our toll-free Helpline to apply for help.
If you have questions about getting the care that you need through NC Medicaid, contact the NC Medicaid Ombudsman. The NC Medicaid Ombudsman is an independent organization that provides education, guidance and referrals to ensure that the more than two million North Carolinians with Medicaid coverage are able to access the health care and services they need.
You can contact the Ombudsman when:
- You are not getting the care that you need.
- You have questions about a notice or bill you have received.
- You have already talked with your health care provider or health plan and have not been able to solve the problem.
- You have general questions about the complaint or appeal process.
To contact the NC Medicaid Ombudsman:
- Visit their website and fill out their online application, or
- Call them at 877-201-3750 (TTY: 711 or RelayNC.com) from 8 a.m. to 5 p.m., every Monday through Friday except for state holidays, or
- Email them at email@example.com.
Additional Helpful Links
How do I apply for Medicaid?
- You apply by contacting your local Department of Social Services (DSS). Click here to find your local DSS.
- You can also apply online at North Carolina ePASS.
Who do I contact if I have a problem and don’t know what to do?
- You can contact the NC Medicaid Ombudsman. To contact them:
Who do I call if I need help choosing a managed care plan or need to change plans?
- You can call the Enrollment Broker (Maximus) at 833-870-5500 (TTY: 833-870-5500).
- You may also mail or fax a completed Health Plan Change Form. Here is the form: NC Medicaid Managed Care, Health Plan Change Request (ncmedicaidplans.gov)
Who do I call if I want to change my Primary Care Provider?
You should call Member Services for your Prepaid Health Plan. Here is their contact information:
- Amerihealth Caritas: 855-375-8811
- Carolina Complete Health: 833-552-3876, extension 2
- Healthy Blue: 844-594-5070
- United Healthcare Community Plan: 800-493-4647
- Wellcare: 866-799-5318
Who do I contact if my health care services have been denied, changed, reduced, or terminated?
- You can call Legal Aid of North Carolina's statewide Helpline at 866-219-5262 (toll-free).
- You may also apply online.
Due to the ongoing COVID-19 pandemic, we now hold all of our clinics electronically using Facebook Live and Zoom. All of the clinics are still completely free and open to the public.
- Facebook Live: To participate using Facebook, visit our Facebook Live page when the clinic starts. You do not need a Facebook account to watch the presentation, but you do need an account to send questions to the presenters. Sign up for a free Facebook account.
- Zoom: To participate using Zoom, use the listing below to register for the clinic you are interested in. You do not need a Zoom account to participate in the clinic. Once you register, you will receive an email containing a link to the Zoom presentation. When the clinic starts, click the Zoom link to join.