Welcome to the 2007 NC Medicaid and NC Health Choice Provider Seminar - ncdhhs-2025

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N.C. has several different Medicaid programs; Access East works directly with the two most common: Medicaid Managed Care: The largest NC Medicaid program. People join one of several available standard health plans, officially known as prepaid health plans, or PHPs.
0:49 2:41 One common way is through the recipient eligibility verification system or revs. This system allowsMoreOne common way is through the recipient eligibility verification system or revs. This system allows providers to check online or use an automated phone system to confirm a patients eligibility.
All program-specific Clinical Coverage Policies can be found on the NCDHHS website.
An adult ages 19-64 may be eligible if the family income is $2,351/month or less. An adult ages 65+ may be eligible for full Medicaid if the family income is $1,704/month or less, and for other programs if the family income is $2,300/month or less.
To contact the NCTracks Call Center to inquire on recipient eligibility in NC FAST, dial 1-800-688-6696.
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To learn more about NC Medicaid Direct, call the NC Medicaid Contact Center at 1-888-245-0179.
North Carolinas Transformation to NC Medicaid Managed Care On July 1, 2021, most Medicaid beneficiaries began receiving the same Medicaid services under NC Medicaid Managed Care. With managed care, beneficiaries choose a health plan and get care through the health plans network of doctors.
You can use the NC Medicaid Provider and Health Plan Lookup Tool to find a primary care provider (PCP). Our provider search can help you find the best PCP for you and your family. To search for a provider, go to Find a provider. You can also read Tips for choosing a primary care provider (PCP).

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