Open Enrollment Begins For N.C. Medicaid Managed Care

Jul 16, 2019

More than 30 states use some form of managed care to deliver Medicaid benefits.
Credit Tulane Publications / Flickr, Creative Commons

Open enrollment began this week for 540,000 Medicaid recipients in North Carolina who will be transitioning from fee-for-service to a managed care system.

"This change is the most signifigant one that has happend in the Medicaid program since its inception," said Debra Farrington, chief of staff of the N.C. Medicaid program.

Farrington said enrollees will be asked to select from a number of pre-paid health plans administered by private entities contracting with the state and physicians.

"I think there will be a lot of supports available to beneficiaries who will be working with the health plans," said Farrington. "The pre-paid health plans will have member services staff who will be able to answer questions, and the members can also access care managers who are people who can work one-on-one with individuals to understand their health conditions and get referred to the right physicians."

The deadline to enroll for the initial phase is September 13, but those who miss that milestone will still be covered.

"If a person doesn't chose a health plan by the middle of September, then they will be assigned a health plan," said Farrington. "After a person is assigned a health plan, they can still change. Individuals will have 90 days from Nov. 1 to make a change."

The first phase is open to Medicaid beneficiaries in 27 counties. Enrollment for the remaining counties will open in the fall. Ultimately, 1.6 million North Carolinians will make the switch to Medicaid managed care, approved by the General Assembly in 2015 as a way to cut costs. The majority of states in the U.S. use some form of managed care to deliver Medicaid benefits.