Questions and Answers for New Members

What is AmeriHealth Caritas North Carolina?

AmeriHealth Caritas North Carolina is a prepaid health plan (PHP) and a member of the AmeriHealth Caritas Family of Companies, a national leader of Medicaid managed care. AmeriHealth Caritas North Carolina is honored to have been selected as one of the prepaid health plans to administer health care services to participants in the NC Medicaid managed care program.

Headquartered in Raleigh, AmeriHealth Caritas North Carolina is a mission-driven health care organization. We emphasize preventive care, health maintenance and community outreach programs.

At AmeriHealth Caritas North Carolina, care is the heart of our work.

What is Medicaid?

Medicaid is a government program that provides health care coverage for low-income adults, children, pregnant women, seniors, people with disabilities, and eligible individuals requiring long-term care.

What is Medicaid managed care?

Medicaid managed care is a program in which a state provides health plans to deliver health care services to Medicaid beneficiaries. The goal of Medicaid managed care is to reduce overall medical costs and promote better health outcomes. Many people get their health benefits through managed care, which helps coordinate and manage all your health care services.

How do I choose a plan?

If you want help choosing a plan, an independent team of enrollment specialists can give you more information about the health plans available to you. Call an enrollment specialist at 833-870-5500 (TTY 833-870-5588) or visit the NC Medicaid Plans website.

If I enroll with AmeriHealth Caritas North Carolina, will I lose my regular Medicaid benefits?

No. You will keep all of the same Medicaid benefits that you're currently eligible for today.

Will my family be on a different health plan or are we able to stay on the same plan?

Your family can choose to be on one health plan or split up between plans. Each person can only be a member of one health plan.

What if I want to change my selected or assigned health plan?

New members can change health plans during the first 90 calendar days following the date of their enrollment. You can also switch health plans one time a year without cause. Certain members can change health plans at any time without cause. If you want to change your health plan, call 1-833-870-5500 (TTY 1-833-870-5588) between 7 a.m. and 5 p.m., Monday through Saturday.

What is the Care Needs Screening?

All AmeriHealth Caritas North Carolina members are encouraged to complete the Care Needs Screening survey that came in your welcome packet or complete it online here. The screening will help us understand your needs and how to best support you with programs and services. If you complete the screening within 90 days of enrolling with AmeriHealth Caritas North Carolina, you will receive a $25 reward on your CARE Card.

What will I receive as a new member?

Once you are enrolled with AmeriHealth Caritas North Carolina, you will receive a Welcome Kit. The information in this kit tells you about our plan, benefits and services. The kit will include the member handbook and Medicaid card. It will also have information on how to change your primary care provider. You can also access this information online through our New Members section.

What are the benefits and services offered by AmeriHealth Caritas North Carolina?

Visit our members section to learn more about the benefits and services we offer.

Does my health care provider participate with AmeriHealth Caritas North Carolina? Is my provider on your plan? Does my provider participate in your network?

We are actively enrolling providers within your area. Your provider may be in the process of being enrolled. You can also use our online provider search tool to find a provider — including medical practices or hospitals — already in our network.

Will my benefits change?

No. You will not lose any of your current benefits received through Medicaid. In fact, you may be eligible for additional benefits through AmeriHealth Caritas North Carolina.