Medicaid Has Changed in North Carolina! Find out information on how these changes in Medicaid services affect your child's care at Carolina Pediatric Therapy.
What NC Medicaid Managed Care Plans Are Available?
There are currently 7 different NC managed Medicaid plans and each of them provide various medicaid benefits. They are administered by:
- Blue Cross and Blue Shield
- United HealthCare
- AmeriHealth Caritas
- Carolina Complete Health
- Eastern Band of the Cherokee (EBCI)
For questions about a specific health plan, how you can contact them, and see any extra benefits they offer, visit the NC Medicaid Division of Health Benefits (NCDHHS).
Frequently Asked Questions About NC Medicaid Managed Care Plans
Before you choose a plan, there is some information you will want to explore. We have prepared these Frequently Asked Questions (FAQs) to help guide our families in their decision-making process as to the best health plan that suits your specific situation.
For Which Plans is Carolina Pediatric Therapy a Provider?
We are enrolled as providers for all of the Managed Medicaid Plans that are offered across all counties. We are currently awaiting acceptance into the network for EBCI.
I've Heard About Tailored Plans. Are You In-Network For Those?
Tailored plans have not rolled out yet and will not be made available until July 2022.
What is NC Direct Medicaid?
For children with Medicaid and NC Health Choice Plans who didn’t switch plans by July 2021, your plan is now called NC Direct Medicaid. NC Direct Medicaid will continue to be managed through the State/NC Division of Medical Assistance.
For those who remain on NC Direct Medicaid, nothing will change about your child's policy. You will not be required to enroll in a managed care plan. Depending on your child's area of need, you may be able to stay with your current Medicaid plan hosted by the State.
Who Can Stay With NC Direct Medicaid?
If your child receives or may receive behavioral health services, members may need to stay enrolled in NC Direct Services and their Local Management Entity (LME) in order to continue receiving behavioral health. In the areas we serve, the LMEs include Vaya, Partners, & Cardinal Health.
If your child receives traumatic brain injury support or intellectual or developmental disability (IDD) support, they also may need to remain with NC Direct Medicaid in order to continue receiving those services provided through that program.
If you are unsure if you should stay with NC Direct, check out more details at NC Medicaid Division of Health Benefits.
Do You Need to Choose a Plan?
Although there is the option to continue with NC Direct Medicaid, most people will need to choose one of the managed health care plans. NC Medicaid would have sent you a letter that tells you if you must enroll. To understand how your specific Medicaid service will be affected, consult the NC Medicaid Division of Health Benefits.
Can I Change my Health Plan at Any Time?
You can change your plan only one time, up to 90 days after the start date on your insurance card. After that, you can only change your plan for the following reasons:
- You need services that meet specific needs, such as developmental disability, behavioral health, traumatic brain injury or substance use disorder
- You are a federally recognized tribal member or qualify for services through Indian Health Service (IHS)
For more information, visit NC Medicaid Division of Health Benefits.
I've Searched For Carolina Pediatric Therapy in The List of Providers, But Can't Find it There. How do I Search For Carolina Peds?
Carolina Pediatric Therapy is our "doing business as" name, but our company's enrollment name is Carolina Rehabilitation Specialists, Inc. Even if you are served in one of our community outreach clinics, search for our 9 West Summit Avenue, Asheville, NC 28803 location address. If you see that address under the plan, we are in-network for that plan and can provide continued therapy for your child. Be sure to enroll in a plan where you find our name!
Who Can I Call if I Have Questions About Enrollment?
Your local county Department of Social Services (DSS) will play a role in the enrollment process and case managers are trained to assist beneficiaries with enrollment decisions.
Visit the NC Medicaid Division of Health Benefits website to locate your local DSS.
How do I Know my Region?
How do I know my Region? Find your county on the map below.