Embedded Files
Presumptive Eligibility for Pregnant Women
NC Division of Medical Assistance Presentation on PE
Issue Brief: Background on Presumptive Eligibility
Medicaid Enrollment Data
Division of Medical Assistance Dashboards
Medicaid Coverage Gap
Individuals fall into the Coverage Gap when they don't earn enough to qualify for financial assistance for plans available on the Marketplace but earn too much to qualify for Medicaid. There are an estimated 212,000 North Carolinians in the Coverage Gap.
Who's in the Coverage Gap? (flyer from Care4Carolina)
Medicaid Coverage Gap 101 video (2:31 running time, Center on Budget & Policy Priorities)
Application & Enrollment Resources
Application
Web Application Portal: ePASS
Medicaid & NC Health Choice Paper Applications
County Department of Social Services Information
Where to Start Chart: ePASS vs. Marketplace
Eligibility Information
General Eligibility
Medicaid Basics Webinar (2016)
Webpage: NC Integrated Eligibility Manual
Webpage: NC Medicaid Webpage
Webpage: Program Definitions
Immigration Information
Quick Reference Guide: NC Health Insurance Eligibility for Immigrants
Eligibility Information for Specific Populations
Medicaid and CHIP FAQs: Coverage for Former Foster Care Children
Household Rules
Medicaid Managed Care
Fact Sheets
Who Needs to Choose a Pre-paid Health Plan?
*Not all Medicaid beneficiaries will transition to managed care. The Enrollment Broker can let beneficiaries know if they need to pick a plan.
Map of Regions (All regions launched on July 1, 2021)
Important Dates:
July 1, 2021: Medicaid Managed Care launched statewide
November 30, 2021: Deadline to switch pre-paid health plan (PHP). Beneficiaries should contact the Enrollment Broker to switch their PHP.
November 30, 2021: Deadline for first "without cause" opportunity to switch primary care provider. Beneficiaries should contact their PHP to switch their PCP.
Enrollment Broker Call Center: 1-833-870-5500
TTY: 1-833-870-5588
NC DHHS Beneficiary Engagement Outreach Materials
A variety of materials developed by NC DHHS are available in English and Spanish.
Short video explaining Medicaid Managed Care
Health centers are encouraged to show the video in their waiting areas
Pre-Paid Health Plan Presentations (February 2021)
United Healthcare
Overview Flyer (bilingual)
Extra Benefits Flyer (bilingual)
Recording (starts at 1:39:06)
Passcode: @i8@=s1f
Wellcare
Medicaid Managed Care 101 Refresher webinar (1/22/2021)
NCCHCA Health Center Beneficiary Outreach Materials
The below materials were developed by NCCHCA and a group of health center staff. They can be adapted and used by the health center for outreach to Medicaid beneficiaries. While Medicaid beneficiaries are getting information from NC Medicaid and the Enrollment Broker about Managed Care, the health center may have specific messages to convey to patients.
There are several ways your health center can outreach to Medicaid beneficiaries. Before conducting outreach, there are several things to consider, including:
Cost
Materials patients may receive from other sources, including NC Medicaid
Unique messages health centers may want to convey
Best avenues for distributing information to patients
How the health center will assist patients who ask for help (remember, health centers should refer to the Enrollment Broker for enrollment
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