Medicaid as it transitions to Managed Care
The new NEWS!!
As of November 19, 2019 DHHS has suspended the transition to managed care. Until further notice there will be no change and services will continue as they have. Feel free to read the story here
Due to challenges in the updates required, the whole state will now roll out on Feb 1, 2020. Previously some of the state, Burke and Catawba counties included, were set to roll out on Nov 1, 2019. You will now wait until Feb to begin the new plan changes.
You may already be aware that there are a lot of changes coming to Medicaid for North Carolina recipients. We understand that there is a lot of information available, and some may become very overwhelming to understand exactly what that means to you. We can certainly understand, which is why we have sought out information to help make this clearer.
Coming very soon NC Medicaid will transition to a managed care system. What this means to you is that you now get to choose your insurance provider for Medicaid services. There are several managed care companies that are coming to the area and we want to make sure you make the choice that works best for you.
In Burke and Caldwell Counties, the projected date for roll out of this new system is scheduled for February of 2020. Residents of Catawba County begin November of 2019. This means that there is a lot happening right now to prepare for this and it is important that you are prepared for it.
There will be 2 types of plans for managed care. The standard plan will affect most recipients. The standard plan allows benefits for many of the services that you are already familiar with. The second plan is for behavioral health and Intellectual/development Disability populations (BH I/DD). To qualify for the second plan recipients need additional criteria and have increased access to higher levels of care. The distinction is important for many reasons, but also because this portion of the plan does not roll out until July 2021. If you require a level of care higher than outpatient counseling, you will need to apply for this program before accessing those services.
There are 4 health plans that you can choose from in this area. You are able to sign up for whichever plan you feel meets your needs best. WellCare, Healthy Blue, United Healthcare, and AmeriHealth Caritas will be available in our area. Be sure to read the options carefully, as each has a unique feature to encourage your to join. At this time Clear Perspective is not enrolled with United Healthcare. You are welcome to chose the plan that is best for you, but if you do choose United Healthcare you will need to find another provider for your mental health needs.
This only applies to you if you have only Medicaid. If your coverage is Medicare and Medicaid you do not have to choose a plan.
Review your options
NC DHHS has developed a convenient comparison chart to help you consider which plan is best for your individual needs. Please review them to help you make this choice as the plans begin to roll out.
There's an app for that!!
Use your phone to connect to your plan and make the changes you need!! It will update you on what is coming and what you need to know. You can find the app on the Google Play or App Store through Apple
NC Medicaid Managed Care
If you need additional information or have additional questions you are welcome to contact NC DHHS directly! Do not hesitate to ask. You can go directly to ncmedicaidplans.gov or call them directly at 833-870-5000. They are available from 7 am to 8 pm 7 days a week. Be sure to have y our medicaid number available for reference.