All patients currently covered by Medicaid or NC HealthChoice must select a primary care physician (PCP) and new Private Health Plan (PHP). The new deadline for PCP and PHP selection has been extended until 12/13/2019! See below for info how!
There are still some challenges to the enrollment broker’s website, but our patients can now go online at www.NCMedicaidplans.gov, or call or use the App, to select Burlington Pediatrics as your PCP and pick your PHP. (See post picture for contact info.)
1. All of our offices and providers are accepting the WellCare and the United Healthcare Community Plan options. We are not accepting any other Medicaid PHP plans at this time.
2. Their website may not show all of our providers as it is still being corrected. All of our providers should show at all three office addresses and all providers are participating with the UHC and WellCare options. If your preferred location and/or provider is not showing, it is ok to select any of our providers or locations—you will still be able to go to any of our locations and be seen by any of our providers.
3. On their website, Mebane Pediatrics is listed as Burlington Pediatrics with the address of 3940 Arrowhead Blvd, Mebane, NC. We have asked for the name to be corrected, but It is ok to go ahead and select.
4. If you’re not sure of the name of your preferred provider, please refer to our website where all of our providers are pictured: https://www.burlingtonpeds.com/providers/
5. If you do not go and choose your PCP and PHP yourself by the 12/13/19 deadline the State enrollment broker will auto assign you to a PCP and Plan. Waiting for auto assignment will increase the likelihood of patients not being assigned to their preferred provider and plan, so take action today!
6. To choose your new Medicaid Managed Care healthplan and Primary Care Physician, click this link: https://www.ncmedicaidplans.gov/choose
For more information about NC Medicaid Changes Read Below:
In June 2019, many existing Medicaid and NC Healthchoice patients began receiving notices in the mail regarding upcoming changes to North Carolina’s Medicaid and NCHC programs. North Carolina is moving to “Medicaid Managed Care.” This means instead of the State managing your healthcare plan, you will select one of five private insurance companies, called “Prepaid Health Plans or PHPs,” that the State has contracted with to managed your healthcare plan. As a Medicaid or NC Healthchoice covered patient, you will have to take steps to sign up for one of the offered plans and select your primary care physician by contacting the enrollment broker, Maximus, by letter, phone, fax, app, or online. (See contact information below). If you do not make your selections by early September, Maximus will auto assign you to a plan and physician, which may or may not be your preferred provider. In September, it was announced that the new date for these plans to become effective is February 1, 2020 and all counties in North Carolina will start at the same time- this is a change from the initial November 1, 2019 partial roll out plan.
At this time, Burlington and Mebane Pediatrics will be participating with two of the five Medicaid Managed Care plans. We will be participating with WellCare of North Carolina and United Healthcare Community Plan. We do not have plans to contract with the other carriers at this time.
A small number of Medicaid patients are initially excluded from phase 1 of Medicaid Transformation, to learn more click this link: https://www.ncmedicaidplans.gov/…/who-must-choose-health-pl…
To learn more about Medicaid Transformation and what it means, click this link:
(This post is not applicable to patients with private health insurance, only those with NC Medicaid or NC HealthChoice)