Questions and Answers About NC Medicaid Enrollment

North Carolina is changing the way it offers health insurance coverage for majority eligible for Medicaid. Here is some important information about NC Medicaid open enrollment and how to keep your access to Jones Center for Women’s Health and Mind Body Spirit Women’s Health doctors.

Medicaid Transformation Includes the Following New Insurances

  • AmeriHealth Caritas North Carolina
  • Carolina Complete Health
  • Healthy Blue (Blue Cross Blue Shield)
  • United Healthcare Community Plan of North Carolina
  • WellCare of North Carolina

What is it? When does this happen? Will I still have access to my providers at the Jones Center for Women’s Health and Mind Body Spirit Women’s Health?

Medicaid Transformation is changing the way most NC residents will receive Medicaid services. In 2015, the General Assembly enacted Session Law 2015-245. Under this law – Medicaid and NC Health Choice will transition to a Managed Care model.  As a result, NC Medicaid recipients’ coverage will be administered, and payments reimbursed by one of six health plans our patients have selected or have been auto enrolled in by the state. A small percentage of people will stay in Medicaid Direct. If you have Medicaid Family Planning your coverage will remain under Medicaid Direct.

What does this mean for our patients? Can I still see my OB/GYN provider without any interruption or prior authorization from my assigned PCP-Primary Care Provider?

YES! Our practices & providers are enrolled and credentialed with the top 5 health plans. You may continue to schedule appointments for your pregnancy, gynecological or women’s health care.

When does this change happen?

NC Managed Medicaid became effective July 1st, 2021.

How do I prepare for this change?

Please report to your appointment with the new managed care healthcare plan insurance card and picture identification. Try to arrive a few minutes early to allow for verification of coverage. Please note, verification may take a bit longer than normal as we all adjust to this new change.

We appreciate your loyalty to our office and will make every attempt to assist our patients throughout this process. We look forward to continuing our patient/physician relationship and providing you with exemplary care at both of our practice locations.

With Kind Regards,

Jones Center for Women’s Health

Mind, Body, Spirit Women’s Health

 

*Some patients have been auto enrolled to our office as their PCP. We are classified as a specialty office only w/all the Managed Care Health Plans. If you require assistance in changing your PCP, we will make every attempt to help you facilitate this as time permits during your visit. Thank you for your assistance in this regard.