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Your Rights as an AmeriHealth Caritas North Carolina Member

AmeriHealth Caritas North Carolina complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, ethnicity, national origin, age, disability, sex, pregnancy, religion, National Guard or Veteran's status, sexual orientation, and gender identity or expression or any other status protected by federal or state law.

AmeriHealth Caritas North Carolina is committed to complying with all applicable requirements under federal and state law and regulations pertaining to member privacy and confidentiality rights.

As a member of AmeriHealth Caritas North Carolina, you have a right to:

  • Be cared for with respect, without regard for health status, sex, race, color, religion, national origin, age, marital status, sexual orientation or gender identity
  • Be told where, when and how to get the services you need from AmeriHealth Caritas North Carolina
  • Be told by your PCP what health issues you may have, what can be done for you and what will likely be the result, in language you understand
  • Get a second opinion about your care
  • Give your approval of any treatment
  • Give your approval of any plan for your care after that plan has been fully explained to you
  • Refuse care and be told what you may risk if you do
  • Get a copy of your medical record and talk about it with your PCP
  • Ask, if needed, that your medical record be amended or corrected
  • Be sure that your medical record is private and will not be shared with anyone except as required by law, contract or with your approval
  • Use the AmeriHealth Caritas North Carolina complaint process to settle complaints.
  • Use the State Fair Hearing system
  • Appoint someone you trust (relative, friend or lawyer) to speak for you if you are unable to speak for yourself about your care and treatment
  • Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints

Help from Member Services

  • Member Services has people to help you. You can call Member Services at 1-855-375-8811 (TTY 1-866-209-6421), 24 hours a day, seven days a week. 
  • In case of a medical emergency, call 911. 
  • You can call Member Services to get help when you have a question. You may call us to get a PCP, to ask about benefits and services, to get help with referrals, to replace a lost Medicaid card, to report the birth of a new baby, or ask about any change that might affect you or your family’s benefits.
  • If you are or become pregnant, your child will become part of AmeriHealth Caritas North Carolina on the day your child is born. You should call your plan and your local Department of Social Services right away if you become pregnant and let us help you to choose a PCP for both you and your newborn baby before he or she is born. 
  • If English is not your first language, we can help. Just call us and we will find a way to talk with you in your own language. 
  • For people with disabilities: If you have difficulty hearing or need assistance communicating, call us. If you are reading this on behalf of someone who is blind, deaf-blind or has difficulty seeing, we can also help. We can tell you if a PCP’s office is equipped with special communications devices. Also, we have services like:
    • TTY machine. Our TTY phone number is 1-866-209-6421.
    • Information in large print
    • Help in making or getting to appointments
    • Names and addresses of providers who specialize in your condition
    • If you use a wheelchair, we can tell you if a provider's office is wheelchair accessible and assist you in making or getting to appointments

Special aids and services

If you have a hearing, vision or speech disability, you have the right to receive information about your health plan, care and services in a format that you can understand and access. AmeriHealth Caritas North Carolina provides free services to help people communicate effectively with us, like:

  • A TTY machine. Our TTY phone number is 1-866-209-6421.
  • Qualified American Sign Language interpreters
  • Closed captioning
  • Written information in other formats (like large print, audio, accessible electronic format and other formats)

These services are available at no cost. To ask for services, call Member Services at 1-855-375-8811 (TTY 1-866-209-6421).

If you believe that AmeriHealth Caritas North Carolina failed to provide these services, you can file a complaint. To file a complaint or to learn more, call Member Services at 1-855-375-8811 (TTY 1-866-209-6421).