North Carolina Medicaid

Most NC Medicaid enrollees receive care through managed care health plans, and NC uses two distinct plan types. Understanding which type applies to you matters because it determines which health plan you'll enroll in and what services are managed where.

Standard Plans cover physical health services for most enrollees. Four Standard Plans operate statewide: UnitedHealthcare Community Plan (1-800-349-1855), HealthyBlue through Blue Cross NC (1-844-594-5070), AmeriHealth Caritas NC (1-855-375-8811), and Carolina Complete Health through Centene (1-833-552-3876). These plans handle primary care, specialty visits, hospital stays, pharmacy, and dental.

Tailored Plans serve enrollees with behavioral health needs, intellectual or developmental disabilities (I/DD), or traumatic brain injuries (TBI). Four Tailored Plans serve different regions of the state: Alliance Health (1-800-510-9132), Partners Health Management (1-888-235-4673), Trillium Health Resources (1-877-685-2415), and Vaya Health (1-800-962-9003). Tailored Plan enrollees receive both physical and behavioral health services through a single plan.

A small group of enrollees — including those with Medicare and certain medically complex cases — remain in NC Medicaid Direct, which is fee-for-service rather than managed care. Contact the NC Medicaid Contact Center at 1-888-245-0179 if you're unsure which option applies to you.

NCDHHS's Division of Health Benefits (DHB) runs the program at the state level. Day-to-day enrollment and eligibility decisions happen through the 100 county Departments of Social Services (DSS). Each county has its own DSS office, and applications submitted in person go through that local office. You can also apply or manage your coverage online through ePASS at epass.nc.gov.

NC Medicaid covers a broad range of services. Standard Plan enrollees receive physical health care through their health plan, including hospital care, primary care visits, specialist visits, prescription drugs, mental health services, substance use treatment, and dental. Children under 21 receive Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, which means all medically necessary care must be covered regardless of whether it appears on the standard benefit list.

Seniors and people with disabilities who need long-term services and supports may qualify for home- and community-based waiver programs, primarily CAP/DA (Community Alternatives Program for Disabled Adults). Nursing facility care is also covered for those who meet medical and financial criteria.

See the sections below for detail on dental coverage, income limits, and long-term care.

Information on this page is for general reference. NC Medicaid rules change. Verify eligibility and coverage details at medicaid.ncdhhs.gov or by calling 1-888-245-0179. Last verified: June 2026.