What is changing?

North Carolina’s Medicaid program is changing. It will go from a state-run program to a managed care model. Managed care models are designed to better manage costs, use and quality of health care services. The new program will include 5 new Medicaid health plans, called Prepaid Health Plans (PHP).

Under the new Medicaid Managed Care program, most but not all NC Medicaid and NC Health Choice patients will need to:

  • Pick 1 of the 5 new health plans
  • Choose a Primary Care Provider (PCP) and the office address you see them at

All of the plans offer the same basic health care benefits and services. However, the doctors and hospitals included in each health plan may be different. The health plans also offer different non health care related services.

 

What You Need to Know About NC Medicaid Changes

Most NC Medicaid and NC Health Choice patients will have the chance to enroll in a new Medicaid plan and choose their primary care provider (PCP) during open enrollment from March 15, 2021 to May 14, 2021.

 


How do I know if my Scotland Health doctor is in a new NC Medicaid health plan?

Scotland Memorial Hospital and Scotland Health doctors are in-network with all of the new Medicaid plans.  Those are:

  • HealthyBlue
  • Carolina Complete Health
  • United Healthcare
  • WellCare
  • NC Medicaid Direct
  • AmeriHealth Caritas NC

“In-network” means that Scotland Health will accept the plan. Visit this website often for updates to see which NC Medicaid plans will be accepted at Scotland Health.

Important: If you have a medical emergency, you should go to the closest hospital emergency room. Scotland Memorial Hospital provides services to all patients seeking treatment for an emergency medical condition. It doesn’t matter what health insurance plan you have or if you can pay for emergency services.