Medicaid Transformation is changing the way people receive Medicaid coverage in North Carolina. In 2021, North Carolina will begin the transition to a Medicaid Managed Care model. The services you receive today will still be covered by Medicaid, but they'll be managed under one of two types of health plans. These changes help combine services for behavioral health care, physical health care, and pharmaceutical coverage under one plan. It simplifies how you receive coverage so you can get better and more coordinated care for your overall health needs.

Your Medicaid eligibility is not changing, but the organization that covers your Medicaid services may change in the future depending on your needs. The Medicaid Transformation process will require all current Medicaid recipients to confirm enrollment under one of two health plan options: Tailored (NC Medicaid Direct with an LME/MCO like Cardinal Innovations) or Standard (Medicaid Managed Care). This process will also require all Medicaid recipients to choose a primary care provider. The right choice in health plan and provider will depend on your unique health needs or diagnosis. 

To learn more about managed care, watch this video from NCDHHS, or visit the NCDHHS Medicaid Transformation website where Medicaid beneficiaries can enroll in their preferred health plan. 

Para obtener más información sobre la atención administrada, vea este video de NCHHS, o visite el sitio web de NCDHHS Medicaid Transformation donde los beneficiarios de Medicaid pueden inscribirse en su plan de salud preferido.