NC Medicaid Managed Care Beneficiary Q&A - Enrollment, PCP, Plans & Deadlines

Sep 19, 2026

NC Medicaid Managed Care beneficiary Q&A explains how Medicaid services are delivered through multiple health plans and how those plans organize networks of doctors, clinics, and added support programs. It clarifies the roles of a primary care provider (PCP) and a health plan, distinguishes NC Medicaid Managed Care from NC Medicaid Direct, and states that Medicaid eligibility rules do not change. It also covers enrollment steps, enrollment deadlines by county, service continuity after enrollment, and options to change plans within the first 90 days.

LanguageEnglish

CategoryForms

FormatPDF

Pages6

Reading Time2 min

AccessFree to download

NC Medicaid Managed Care Overview

What is NC Medicaid Managed Care

What is NC Medicaid Direct

What is a primary care provider (PCP)

What is a health plan

Enrollment Requirements and Deadlines

Do I have to choose a health plan

What do I need to do

What is the deadline to enroll

After Enrollment and Plan Changes

What happens after I enroll

Can I change my health plan after I enroll

GET ANSWERS We’re here to help you understand your primary care provider (PCP) and health plan choices. Here are answers to questions you may have. If you have other questions, call us toll free at 1-833-870-5500 (TTY: 1-833-870-5588) . Or use the chat tool to chat with us online. What is NC Medicaid Managed Care? NC Medicaid Managed Care helps you get the most out of your Medicaid benefits. Instead of one Medicaid program there are many health plans to choose from. All health plans are required to have the same Medicaid services, such as office visits, blood tests and X-rays. Health plans also have added services such as programs to help you quit smoking, eat healthier and have a healthy pregnancy. Health plans work with different doctors and health care professionals. Each plan has its own network of qualified doctors and health care professionals. To keep your doctor, clinic or other provider, find out which plans they work with. Then choose oneof those plans. What is NC Medicaid Direct? Some people will be in NC Medicaid Direct because it provides services that meet specific needs. For example, it provides the same services currently covered for developmental disability, mental illness, traumatic brain injury and substance use disorder. To learn more about NC Medicaid Direct, call 1-888-245-0179. Is Medicaid eligibility changing? No. Medicaid eligibility rules are not changing. If you have questions about your eligibility, contact your local Department of Social Services (DSS) office. Find contact information at [ncdhhs.gov/localdss](ncdhhs.gov/localdss). What is a primary care provider (PCP)? Your primary care provider (PCP) is your family doctor, clinic or health care provider. Your PCP will help you with your health care needs. They will also coordinate your care with other health providers. What is a health plan? A health plan is a group of doctors, hospitals and other health care professionals. They work together to give you the health care you need. Do I have to choose a health plan? It depends. Most people in NC Medicaid must choose a health plan. Some people can choose to stay in NC Medicaid Direct. They will not need to choose a plan. To find out if you must enroll, go to Who must enroll in NC Medicaid Managed Care? at [ncmedicaidplans.gov/learn/who-must-enroll-nc-medicaid-managed-care](ncmedicaidplans.gov/learn/who-must-enroll-nc-medicaid-managed-care. If you)[. If you](ncmedicaidplans.gov/learn/who-must-enroll-nc-medicaid-managed-care. If you) still have questions, call us toll free at 1-833-870-5500 (TTY: 1-833-870-5588) . Or use the chat tool to chat with us online. Will I lose any services when I enroll? No. You will not lose any services. Health plans may also offer added services. What do I need to do? 1 Choose a primary care provider (PCP) 2 Choose a health plan – compare the plans and choose the best one for you 3 Enroll online, use the NC Medicaid Managed Care mobile app, call us toll free at 1-833-870-5500 (TTY: 1-833-870-5588) or fill out and mail back the enrollment form sent to you What is the deadline to enroll? Enroll by September 13, 2019 if you live in one of these counties: Alamance, Alleghany, Ashe, Caswell, Chatham, Davidson, Davie, Durham, Forsyth, Franklin, Granville, Guilford, Johnston, Nash, Orange, Person, Randolph, Rockingham, Stokes, Surry, Vance, Wake, Warren, Watauga, Wilkes, Wilson, Yadkin Enroll by December 13, 2019 if you live in one of these counties: Alexander, Anson, Avery, Beaufort, Bertie, Bladen, Brunswick, Buncombe, Burke, Cabarrus, Caldwell, Camden, Carteret, Catawba, Cherokee, Chowan, Clay, Cleveland, Columbus, Craven, Cumberland, Currituck, Dare, Duplin, Edgecombe, Gaston, Gates, Graham, Greene, Halifax, Harnett, Haywood, Henderson, Hertford, Hoke, Hyde, Iredell, Jackson, Jones, Lee, Lenoir, Lincoln, McDowell, Macon, Madison, Martin, Mecklenburg, Mitchell, Montgomery, Moore, New Hanover, Northampton, Onslow, Pamlico

FAQs

What is NC Medicaid Managed Care and how is it different from choosing one program?

NC Medicaid Managed Care uses multiple health plans to deliver Medicaid benefits instead of a single Medicaid program. All plans must provide the same Medicaid services, and may also add extra services.

What is a primary care provider (PCP) and what do they do?

A PCP is a family doctor, clinic, or health care provider who helps meet your health care needs. They also coordinate your care with other health providers.

How do I enroll and what are the enrollment deadlines?

Enrollment involves choosing a PCP, choosing a health plan, and enrolling online, via the mobile app, by phone, or by mailing back the enrollment form. Deadlines depend on the county, with September 13, 2019 and December 13, 2019 listed for different county groups.

Sep 19, 2026

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