Medicaid expansion starts December 1. Are you ready?
The state of North Carolina is expecting a flood of new patients in waiting rooms on December 1, when Medicaid expansion lets roughly 600,000 people gain greater access to healthcare. In advance of potentially full waiting rooms and confusion, the NC Department of Health and Human Services has issued some tips. Here is some help:
WHAT PROVIDERS NEED TO KNOW AND DO
- A robust provider network ready to serve newly enrolled beneficiaries is critical to success. To become a Medicaid enrolled provider, visit the NCTracks Provider Enrollment webpage.
- Once enrolled, providers can contract with the health plans in their area. See the NCMedicaid Provider Contracting with Health Plans webpage for more information.
- If you are a currently enrolled Medicaid provider, check to make sure your information is correct in NCTracks, including whether you are accepting new patients. See the NCTracks Manage Change Request FAQs for more information about the managed change request process.
- Monitor your secure NCTracks Provider Message Inbox and Status and Management page for notification of required actions, like reverification.
- New program aid categories will be created for beneficiaries eligible due to Medicaid expansion. These will display for eligibie beneficiaries in Category of Eligibilty section of the NCTracks Recipient Eligibility Verfication feature:
- Managed Care Enrolled (full Medicaid benefit):
- MXPNN – Adult Medicaid Expansion, Categorically Needy
- MCPGN — Adult Medicaid Expansion, Categorically Qualified Alien
- Emergency Services Only:
- MXPFN – Adult Medicaid Expansion, Categorically Needy Non-Qualified Alien, Emergency Services only
- MXPHN – Adult Medicaid Expansion, Categorically Needy, Emergency Services only
- Managed Care Enrolled (full Medicaid benefit):
HOW CAN PROVIDERS ASSIST NC MEDICAID BENEFICIARIES?
- Providers can help by offering services to beneficiaries enrolled in these program and encouraging patients to apply. The Department will also be sharing a toolkit with resources to share with your patients and community.
- Individuals can apply for Medicaid in one of four ways:
- Online (https://epass.nc.gov/) – English and Spanish portal available
- Paper application
- In person at their local Department of Social Services (DSS) office
- By calling their local DSS office
- More information on applying for Medicaid coverage is available at https://ncgov.servicenowservices.com/sp_beneficiary?id=bnf_apply:
- Interested individuals may review the NC Medicaid eligibility criteria for more information before applying.
- It may take up to 45 days for someone to find out if they are eligible. Incomplete applications may take longer. Applications submitted online often process faster. If an individual cannot apply online, they may utilize one of the other options listed above to apply.