United Healthcare North Carolina Medicaid

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Extra Help With Costs: Lis Premium Summary Table

NC Medicaid change results in delayed payments for some small healthcare providers

UnitedHealthcare Dual Complete®

Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

This table shows you what your monthly plan premium will be if you get extra help.

Your level of extra helpMonthly Premium*

*This does not include any Medicare Part B premium you may have to pay.

If you arent getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare of TTY users call 1-877-486-2048 ,
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

Your health care needs are unique. These documents can help you make sure you get the right coverage.

Documents include Annual Notice of Changes, Evidence of Coverage, Formularies, Medicare Plan Star Ratings, Provider Directories, Summary Benefits, Other downloadable resources.

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See What Unitedhealthcare Has To Offer

Its your health. Its your choice.

Everyone deserves affordable health care, including you.

That includes working adults, people with disabilities, pregnant women and children.

If thats you, check out UnitedHealthcare Community Plan Medicaid.

We have the Medicaid services and extras that can make a real difference in your life. All at no cost to you.

  • Find a doctor you trust in our network.
  • Unlimited doctor visits for adults.
  • Vision coverage.
  • Transportation to and from doctor appointments.
  • 24/7 NurseLine to answer your health questions.

Sometimes, you might need a little extra help. Get extras not covered by Medicaid.

  • Earn rewards for keeping you and your baby healthy.
  • Earn gift cards for getting preventative services.
  • Support and treatment to reach a healthy weight.
  • Members 18 and older can get free GED Exam Voucher and materials.

We also offer resources to help you make the most of your plan. Including:

  • Member Advocates

Visit NC medicaidplans dot gov for more information.

Helping you live a healthier life.

We are here for you, North Carolina

Remember to choose UnitedHealthcare Community Plan.

And get the Plan that gets you more.

To learn more about UnitedHealthcare Community Plan, visit UHCCommunityPlan.com forward slash NC.

Discount valid until 12/31/22. Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members.

Looking for the federal governments Medicaid website? Look here at Medicaid.gov.

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What Type Of Health Insurance Exchange Does North Carolina Have

North Carolina uses the federally run exchange , and has not yet expanded Medicaid under the ACA. 535,803 people enrolled in qualified health plans through North Carolinas exchange during the open enrollment period for 2021. Only California, Florida, and Texas had higher QHP enrollment in their marketplaces.

Which Health Insurance Carriers Offer 2022 Coverage In The North Carolina Marketplace

Insurance

For 2022, the following insurers will offer plans in the marketplace in North Carolina, with localized coverage areas:

  • Blue Cross Blue Shield of North Carolina
  • Cigna
  • Celtic/WellCare
  • AmeriHealth Caritas

There are a total of six insurers that offer coverage in North Carolinas exchange as of 2021, although as described below, four additional insurers will be offering plans in the exchange for 2022.

Cigna joined the exchange starting in 2017 in the Raleigh/Durham area . Ambetter entered the ACA-compliant individual market in Durham and Wake counties in North Carolina for 2019 coverage, and Bright Health began offering plans in the Charlotte and Winston-Salem areas as of 2020. Oscar joined North Carolinas exchange as of 2021, and UnitedHealthcare rejoined as of 2021, bringing the total number of participating insurers to six.

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How Will Premiums In North Carolina’s Individual Market Change For 2022

There will be ten insurers offering plans in North Carolinas marketplace for 2022. The six insurers that offer plans in the marketplace in 2021 have proposed the following average rate changes for 2022 :

  • Blue Cross Blue Shield of North Carolina: Average proposed rate increase of 9.43%
  • Cigna: Average proposed rate increase of 6.46%
  • Ambetter/Centene: Average proposed rate of 5.1%
  • Bright Health: Average proposed rate increase of 8.23%
  • Oscar: Average proposed rate of 2%
  • UnitedHealthcare: Average proposed rate of 6.06%
  • Aetna CVS Health: New for 2022, so no applicable rate change
  • Friday Health Plans: New for 2022, so no applicable rate change
  • AmeriHealth Caritas: New for 2022, so no applicable rate change
  • Celtic/WellCare: New for 2022, so no applicable rate change

The proposed rates are under review by the North Carolina Department of Insurance, and will be finalized by the fall of 2021. Open enrollment for 2022 health coverage will begin November 1, 2021.

American Disabilities Act Notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 , UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

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North Carolina Health Plans As Low As $0 Cost

UHC NC Medicaid Plans:

  • Low income individuals and families
  • All ages

NC Individual and Family Plans:

  • Up to 6 $0 virtual urgent care and virtual primary care visits
  • Digital fitness classes at no additional cost
  • $3 copays on Tier 1 generic drugs at Walgreens
  • $0 copay for 3 primary care visits
  • Earn a $25 gift card for visiting your doctor
  • $0 routine dental visits and preventive care for adults on select plans

Online Medicaid Suboxone Treatment In North Carolina

How to Navigate The NC Medicaid Transformation

Suboxone is an FDA-approved medication used to treat Opioid Use Disorder . Suboxone helps reduce cravings and can help patients break from their addiction.

Our doctors accept most major insurance plans including Medicaid. Most patients save $200 a month by switching to us! Find an Online Medicaid Suboxone Doctor in North Carolina today.

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Visitas Ilimitadas Al Mdico

Puede suceder que su salud o la de un miembro de su familia requiera visitas regulares a un proveedor de atención primaria . Nuestro plan no limita la cantidad de veces que usted puede visitar a su PCP. De esta forma, obtiene cuidados cuando los necesita. Y su médico puede ver cómo progresa su salud.

Vea Lo Que Unitedhealthcare Tiene Para Ofrecer

Es su salud. Es su elección.

Todos merecen una atención médica asequible, incluido usted.

Eso incluye a adultos que trabajan, personas con discapacidad, mujeres embarazadas y niños.

Si ese es usted, conozca UnitedHealthcare Community Plan Medicaid.

Tenemos los servicios y beneficios adicionales de Medicaid que pueden marcar una diferencia real en su vida. Todo sin ningún costo para usted.

  • Encuentre un médico de nuestra red en el que confíe.
  • Visitas ilimitadas al médico para adultos.
  • Cobertura oftalmológica.
  • Transporte desde y hacia las consultas médicas.
  • NurseLine las 24 horas del día, los 7 días de la semana para responder sus preguntas sobre salud.

Algunas veces, puede que necesite un poco más de ayuda. Obtenga beneficios adicionales no cubiertos por Medicaid.

  • Obtenga recompensas al mismo tiempo que conserva su salud y la de su bebé.
  • Obtenga tarjetas de regalo por recibir servicios preventivos.
  • Asistencia y tratamiento para alcanzar un peso saludable.
  • Los miembros de 18 años de edad y más pueden obtener un cupón para el examen GED y materiales gratis .

También ofrecemos recursos para ayudarlo a aprovechar al máximo su plan. Incluyen:

  • Defensores de miembros
  • Herramientas de educación sobre salud
  • Administración de cuidados

Visite NC medicaidplans punto gov para obtener más información.

Lo ayudamos a vivir una vida más saludable.

Estamos aquí para ayudar, Carolina del Norte

Recuerde elegir UnitedHealthcare Community Plan.

Y obtenga el plan que le ofrece más.

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A Look At North Carolinas Average Rate Increases Since 2014

ACA-compliant plans debuted in 2014, and premiums were essentially insurers educated guesses, since they had no claims experience with these plans.

For 2015, PricewaterhouseCoopers LLC determined a weighted average rate increase of 9.8 percent for individual coverage in North Carolina, including on and off-exchange carriers . This was higher than the national average of 5.4 percent.

The Commonwealth Funds analysis of exchange plans in North Carolina came up with an average rate increase of 12 percent for 2015.

Among the 34 states with fully-HHS-run exchange, only four states had average 2015 premiums for the second-lowest-cost silver plans that were as high or higher than North Carolinas average.

For 2016, the weighted average rate increase in the North Carolina exchange was about 29 percent across all plans (32.5 percent for Blue Cross Blue Shield of North Carolina, 23.6 percent for Aetna/Coventry, and about 20 percent for UnitedHealthcare. North Carolinas Insurance Commissioner Wayne Goodwin blamed the states spiking premiums for 2016 on the General Assembly, because they refused to establish a state-based exchange or expand Medicaid.

Goodwin explained that if had a state-based system, we would have had more companies competing. There would have been more leverage on my end as the Insurance Commissioner and rates would have been lower. If there had been Medicaid expansion, rates would have been lower.

Descargo De Responsabilidad De Los Beneficios De Unitedhealthcare Connected

NC Medicaid billing system offline for providers

Esta no es una lista completa. La información sobre beneficios es un breve resumen, no una descripción completa de los beneficios. Para obtener más información, comuníquese con el plan o lea el Manual para miembros. Es posible que se apliquen limitaciones, copagos y restricciones. Si desea obtener más información, comuníquese con Servicios para Miembros de UnitedHealthcare Connected® o lea el Manual para miembros de UnitedHealthcare Connected®. Los beneficios, la lista de medicamentos cubiertos, las redes de farmacias y proveedores o los copagos pueden cambiar a partir del 1 de enero de cada año.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al de 8:00 a. m. a 8:00 p. m., hora local, de lunes a viernes . La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.

Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes . La llamada es gratuita.

Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

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Unitedhealthcare And Oscar Joined North Carolinas Marketplace For 2021

UnitedHealthcare, which previously offered coverage in North Carolinas marketplace but exited after the end of 2016, returned to the state as of 2021 . UnitedHealthcares plans are only sold on-exchange, and are available in all of rating areas 2, 7, 9, and 13, plus parts of rating areas 1, 11, and 15 .

Oscar also joined the North Carolina marketplace for 2021, with plans available in the Asheville area.

Defensora Comunitaria De Medicaid En Carolina Del Norte

La defensoría comunitaria de Medicaid en Carolina del Norte es un recurso con el que puede comunicarse si necesita ayuda con sus necesidades de cuidados médicos y acceso a recursos locales. La defensoría comunitaria de Medicaid en Carolina del Norte es una organización sin fines de lucro operada de forma independiente cuyo único trabajo es garantizar que las personas y familias que reciben Medicaid de Carolina del Norte y NC Health Choice tengan acceso a los cuidados que necesitan.

La defensoría comunitaria de Medicaid en Carolina del Norte puede hacer lo siguiente:

  • Responder las preguntas sobre los beneficios
  • Ayudarle a comprender sus derechos y responsabilidades
  • Brindar información sobre Medicaid y la atención administrada de Medicaid
  • Responder sus preguntas sobre cómo inscribirse o cancelar su inscripción en un plan de salud
  • Ayudarle a entender un aviso que ha recibido
  • Derivarlo a otras agencias que pueden ayudarlo con sus necesidades de cuidados médicos
  • Ayudarle a resolver los problemas que tenga con su proveedor de atención médica o plan de salud
  • Ser un defensor de los miembros que se enfrentan a un problema o una queja que afecta el acceso a cuidados médicos
  • Brindar información para ayudarlo con su apelación, reclamo, mediación o audiencia estatal imparcial
  • Conectarlo con ayuda legal, si la necesita para resolver un problema con sus necesidades de cuidados médicos.

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Insurer Participation In North Carolinas Exchange: 2014

In 2014, plans were only available through two carriers in North Carolinas exchange: Blue Cross Blue Shield of North Carolina and Coventry Health Care of the Carolinas . But nearly two-thirds of the states 100 counties had only Blue Cross Blue Shield as an option, because Coventry only offered plans in 39 counties.

United Healthcare joined the individual health insurance exchange in North Carolina in 2015 , and the three insurers continued to offer plans in the exchange in 2016 as well. BCBSNC plans were available statewide, Uniteds plans were available in 77 counties, and Aetnas plans were available in 39 counties

UnitedHealthcare exited the individual market entirely in North Carolina at the end of 2016, as was the case in the majority of the states where United offered exchange plans in 2016. Aetna also exited the exchange in North Carolina, along with most of the other states where they were participating in the exchanges.

North Carolina Insurance Commissioner, Wayne Goodwin, expressed his dismay at Aetnas announcement, saying I am shocked and disappointed that Aetna and its executives have chosen to abandon their Exchange members. We at NCDOI were in the middle of reviewing Aetnas rate requests for 2017. Never during the review did the company indicate any concern that the requested rates would not solve. I am angered by the impact Aetnas decision will have on Tar Heel families and our market.

Unitedhealthcare Dual Complete Plans

United Healthcare drops Alabama hospitals from Medicaid coverage plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

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Health Insurance Coverage For Multiple Years

TriTerm Medical Insurance,4 underwritten by Golden Rule Insurance Company, is short term health insurance that offers coverage for preventive care, doctor office visits, and prescriptions.

  • Apply once for insurance coverage terms that equal one day less than 3 years.
  • $2 million lifetime maximum benefit per covered person on most plans.
  • Eligible expenses for preexisting conditions are covered after 12 months on the plan.

How Many People Are Enrolled In North Carolina’s Exchange

535,803 people enrolled in private individual market plans through North Carolianas exchange during the open enrollment period for 2021 coverage, up from 505,275 the year before. Among the states that use HealthCare.gov, only Florida and Texas have higher enrollment than North Carolina . And North Carolina is one of just a handful of states that use HealthCare.gov where enrollment increased from 2019 to 2020 .

Like most states that use HealthCare.gov, enrollment in North Carolinas exchange peaked in 2016. And although enrollment is higher in 2021 than it has been in any year since 2017, its still nearly 13 percent lower than it was in 2016. Heres a summary of total enrollment in individual market plans through North Carolinas exchange during open enrollment each year:

And for 2018, enrollment in HealthCare.gov states was about 5 percent lower in 2018 than it was for 2017, due in part to continued funding cuts for advertising and outreach, combined with an open enrollment period that was half as long as it had been in prior years.

Enrollment dropped again in 2019 in most HealthCare.gov states, thanks in part to the elimination of the federal penalty for being uninsured, as well as the Trump administrations expansion of short-term plans, which serve as an attractive alternative to ACA-compliant plans for some healthy consumers.

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Individual And Family Plans

UnitedHealthcare is offering individual and family plans in North Carolina that are designed to provide the best possible coverage at an affordable price.

We have plan choices in all three metal levels, bronze, silver and gold, offering a variety of benefits. And all of our plans come with reliable, friendly guidance from our experienced team.

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  • Virtual Care Icon

    $0 virtual care

    With most plans, you get $0^ virtual visits with a doctor who’s specially trained to provide online urgent, specialty and primary care.

  • Pill Bottle Icon

    Prescriptions as low as $3

    Pay a $3^ copay on Tier 1 generic drugs at Walgreens. Plus, get member-exclusive discounts, like 20% off Walgreens-brand health and wellness products.

  • Run Icon

    Digital fitness classes at no additional cost

    Get access to a premium library with thousands of live and on-demand digital fitness classes included in your plan.

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