NC Medicaid Open Enrollment is underway through May 14, 2021. There a few important things to know about Open Enrollment this year.
The State of North Carolina is transitioning to a managed care insurance platform effective July 1, 2021. Contracts have been provided to insurance companies who will be responsible for administering your plan benefits. Due to this transition, we want to make you aware of how your plan choice might affect your coverage of services within the Sampson Regional system. Not every hospital or physician is in contract to accept every plan. In order to avoid being subject to out-of-network premiums, plan participants should understand what their plan covers and what services are in network.
For Sampson County residents, the State has issued contracts to AmeriHealth Caritas of North Carolina, Blue Cross and Blue Shield of North Carolina (Healthy Blue), UnitedHealthcare of North Carolina, WellCare of North Carolina, and Carolina Complete Health, Inc.
Sampson Regional Medical Center and its network of providers have signed contracts with WellCare of North Carolina and anticipate signed contracts with Blue Cross and Blue Shield of North Carolina (Healthy Blue) and Carolina Complete Health, Inc.
Managed care lets participants choose a health plan with the providers and services that best suit their healthcare needs. With the transition, current subscribers who do not enroll in a plan by May 14, 2021, may be auto-assigned a healthcare coverage plan by the State of North Carolina. Enrollees will have the option to change their plan after enrollment date if the plan falls out of network with their chosen providers.
While we do not endorse any products or plans, we encourage participants to carefully select their plan. The rules are different between these new insurance plans and the traditional Medicaid program.
Each plan offered to NC Medicaid enrollees is different. Prepaid Health Plans are paid in advance by Medical Assistance to cover healthcare needs of beneficiaries who choose the plan. While this type of plan is required to cover basic benefits, there may be differences in coverage from plan to plan.
Plans change year to year. It is important to fully understand your plan and what benefits are covered. It is also important to re-evaluate your healthcare coverage plan each year.
Know if your preferred providers are contracted with the plan you choose. Not every physician, hospital, or service provider is contracted with all plans.
If you don't have a preferred provider, Sampson Regional Medical Center can help. Click here to find a provider that's right for you.
Help is available through NC Medicaid Contact Center by calling 1-888-0179 or online with NC DHHS.