North Carolina Medicaid's Managed Care Is Changing

If you have Medicaid in North Carolina, you may have gotten a letter in the mail recently saying your health plan is changing. Don’t panic. For most people, nothing will change about how you get your care. Here’s a simple breakdown of what’s happening.

What’s Going On?

Two NC Medicaid health plans, WellCare of North Carolina and Carolina Complete Health, are joining together into one plan on April 1, 2026.

The new combined plan will be called Carolina Complete Health. It will be the biggest Medicaid plan in North Carolina, covering more than 775,000 people.

Using WellCare. What Happens?

Good news, you don’t have to do anything.

• Medicaid coverage will automatically move to Carolina Complete Health on April 1.
• Benefits stay exactly the same.
• You can keep seeing your same doctor.
• You’ll get a new Carolina Complete Health ID card in the mail before April 1. Keep it — you’ll need it at your next doctor’s visit or when you pick up a prescription.

That’s it. No forms to fill out. No calls to make. Your coverage continues without interruption.

Already on Carolina Complete Health. What Happens?

Not much changes for you. Your plan name stays the same and your benefits stay the same.

However, you do have the option to switch to a different plan if you want to. You can do that between March 1 and May 31, 2026.

What If I Don’t Want Carolina Complete Health?

You have options. North Carolina has four Standard Medicaid plans to choose from:

1. Carolina Complete Health (the new merged plan)
2. AmeriHealth Caritas
3. Healthy Blue
4. UnitedHealthcare Community Plan

Before you switch, check that your doctor accepts the new plan you’re considering. Then contact the NC Medicaid Enrollment Broker — they handle all plan changes. Do not call the health plan directly.

How to reach the Enrollment Broker:

• Online: ncmedicaidplans.gov
• By phone: 1-833-870-5500 (TTY: 711)
• By mail or through the NC Medicaid mobile app

Home Care Providers

You’re still in-network. If you were contracted with WellCare or Carolina Complete Health before the merger, you are automatically in-network with the new combined plan on April 1. You do not need to sign anything new or reapply.

Update your billing on April 1. For any home visits or services on or after April 1, 2026, submit claims to Carolina Complete Health. Services before April 1 for WellCare patients should still be billed to WellCare under the old contract. Make sure your billing team knows the cutoff date so claims don’t get sent to the wrong payer.

Check in with your clients about their new ID card. Many of the people you serve may not fully understand the letter they received or may not have read it at all. During your next visit, take a moment to ask if they’ve gotten a new card in the mail. If they haven’t, help them call Carolina Complete Health at 1-833-552-3876 to request one. They’ll need their new card if they visit a doctor, specialist, or pharmacy.

Watch for authorization changes. If any of your clients have active prior authorizations under WellCare, check with Carolina Complete Health to confirm those authorizations carry over after April 1. Don’t assume they automatically transfer — a quick confirmation call can prevent a gap in approved services.

Electronic Visit Verification (EVV) stays the same. If your agency uses EVV to document home visits, the process doesn’t change. Just make sure visit records reflect the correct payer — WellCare for dates before April 1, and Carolina Complete Health for dates on or after April 1.

Bottom Line

For most people, April 1 will come and go without disrupting their care. Your benefits don’t change. You just have a new plan name and a new ID card.