NC Medicaid Rate Reductions Effective Oct. 1, 2025
Fee schedules impacted by rate reductions will be released.
Oct. 1, 2025. Rates are subject to change if additional appropriations are
made.
North Carolina has expanded health care coverage to more people. You might be one of them. Check to see: North Carolina Expands Medicaid | NC Medicaid
NC Medicaid Managed Care Overview Video: Watch this brief video to learn more about the different health plan types for NC Medicaid Managed Care beneficiaries. These include Standard Plans, Tailored Plans, EBCI Tribal Option, the Children and Families Specialty Plan and NC Medicaid Direct.
New Primary Care Provider Change Request Form for Members in Managed Care Prepaid Health Plans: In collaboration with primary care providers (PCPs), the NC Medicaid Managed Care Prepaid Health Plans (PHPs) have created a new standardized PCP Change Request Form for members who wish to change their primary care assignment throughout the year. A link to each health plan’s form can be found here:
- AmeriHealth Caritas North Carolina
- Carolina Complete Health
- Healthy Blue
- United Healthcare Community Plan of North Carolina
- WellCare of North Carolina
As a reminder, beneficiaries can change their PCP/Advanced Medical Home (AMH) without cause twice each year. For more information, please see New Primary Care Provider Change Request Form for Members in Managed Care Prepaid Health Plans.
NC DHHS
The Children and Families Specialty Plan will launch December 1, 2025. Visit health plan types to learn more at Health plan types | NC Medicaid Managed Care.