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Ombudsman Program

The Medicaid Managed Care Ombudsman Program is a resource you can contact if you need help with your health care needs.  The Ombudsman Program is an independently-operated, non-profit organization whose number one priority is to ensure that individuals and families that receive North Carolina Medicaid and NC Health Choice get access to the care that they need.

The Ombudsman Program can:

  • Answer your questions about your benefits
  • Help you to understand your rights and responsibilities
  • Provide information about Medicaid and Medicaid Managed Care
  • Answer your questions about enrolling or disenrolling with a health plan
  • Help you understand a notice you have received
  • Refer you to other agencies that may also be able to assist you with your health care needs
  • Help to resolve issues you are having with your health care provider or health plan
  • Be an advocate for Members dealing with an issue or a complaint affecting access to health care
  • Provide information to assist you with your appeal, grievance, mediation or fair hearing
  • Connect you to legal help if you need it to help resolve a problem with your health care