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Questions and Answers for New Members

What is AmeriHealth Caritas North Carolina?

AmeriHealth Caritas North Carolina is a managed care organization 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 managed care organizations 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 prepaid 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?

The NC Medicaid Enrollment Broker can help you choose and enroll in a plan. Call the NC Medicaid Enrollment Broker at 1-833-870-5500 (TTY 1-833-870-5588) between 7 a.m. and 5 p.m., Monday through Saturday.

I am interested in enrolling in AmeriHealth Caritas North Carolina. How and when can I enroll?

Call the NC Medicaid Enrollment Broker at 1-833-870-5500 (TTY 1-833-870-5588) between 7 a.m. and 5 p.m., Monday through Saturday to enroll.

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 different prepaid health plan (PHP) 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 PHP?

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 NC Medicaid Enrollment Broker at 1-833-870-5500 (TTY 1-833-870-5588) between 7 a.m. and 5 p.m., Monday through Saturday.

Can I still join if I also have Medicare?

Yes. Members may be eligible for both Medicaid and Medicare, depending on income level. The state determines your eligibility.

Will I have a monthly payment?

Call the NC Medicaid Enrollment Broker at 1-833-870-5500 (TTY 1-833-870-5588) between 7 a.m. and 5 p.m., Monday through Saturday for more information.

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 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.