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Frequently Asked Questions

What is Carolina Complete Health?

Carolina Complete Health will begin offering services in 2020 to children, pregnant women, families with children, elderly, adults with disabilities and children with disabilities.

What is a Managed Care Organization (MCO)?

An MCO is an insurance company that contracts with providers and medical facilities to provide health care services to its members.

What services are covered under Carolina Complete Health?

Carolina Complete Health services include physical health, behavioral health, long-term care, and community benefits.

Who may be eligible for services?

In addition to meeting certain income levels, applicants must meet specific eligibility requirements to receive Medicaid coverage. Eligibility for programs and services is determined by the Department of Health and Human Services (DHHS). For more information on North Carolina Medicaid eligibility, please contact the DHHS Contact Center at 1-800-662-7030.

Do I have to pay to be enrolled in Carolina Complete Health?

No. There is no cost to enroll in Carolina Complete Health. Some members may pay minimal copayments for doctor visits, emergency room care and prescriptions.

How do I apply for services?

You can apply for services by phone.

By Phone:

  • 1-833-870-5500 (TTY: 1-833-870-5588)

If I have both Medicare and Medicaid, will I have to change my Medicare plan as part of Carolina Complete Heatlh?

No. Your Medicare services and doctors will stay the same. It’s the responsibility of your Medicaid MCO to coordinate your services with your Medicare Primary Care Provider (PCP).

How do I know if my doctors are contracted with a North Carolina Medicaid MCO?

Ask your doctors if they are contracted with Carolina Complete Health.

You can check the Find A Doctor webpage on our website to view our online provider directory or consult our Provider Directory.

If you have questions about our doctors, contact Carolina Complete Health Member Services at 1-833-552-3876 (TTY: 711).

Can I change my Primary Care Provider (PCP)?

To change your PCP, call Member Services at 1-833-552-3876 (TTY: 711).

I need to see a specialist, what do I need to do?

Your PCP must request a referral for you to see a specialist. If you would like additional information, you may contact Carolina Complete Health Member Services at 1-833-552-3876 (TTY: 711).

What is a Community Benefit?

The “Community Benefit” is the name given to a set of services that help to keep people in their homes and communities. Some of these services include adult day health, respite care, and personal care services.