With Medicaid open enrollment swiftly underway, Sampson Regional Medical Center (SampsonRMC) encourages participants to review their plan options closely. As the state transitions to a managed care insurance platform effective July 1, 2021, this opens up many options for current Medicaid participants.
The State of North Carolina has awarded contracts to provide Medical Assistance health insurance to replace the previous statewide Medicaid plan. For Sampson County, the State has issued contracts to AmeriHealth Caritas of North Carolina, Blue Cross and Blue Shield of North Carolina (Healthy Blue), United Healthcare of North Carolina, WellCare of North Carolina, and Carolina Complete Health, Inc.
At this point, SampsonRMC, hospital-owned practices, and outpatient service areas have signed a contract with WellCare of North Carolina and anticipate signed contracts with Healthy Blue and Carolina Complete Health, Inc. when new plans begin on July 1, 2021. "It is important for Medicaid participants to understand who we are in contract with to ensure they are not subject to out-of-network premiums for the care received," stated Jerry Heinzman, Chief Financial Officer for SampsonRMC.
"While we cannot endorse any products or plans, we encourage participants to be careful when selecting their plan. The rules are different between these new insurance plans and the traditional Medicaid program; not every physician, hospital, or service provider is in contract with every insurer," added Heinzman.
With the new managed care program, participants choose a health plan with the providers and services that best suit their healthcare needs. As stated on the NCDHHS website dedicated to North Carolina's transformation to Medicaid managed care, current subscribers who do not enroll in a plan by May 14, 2021, may be auto-assigned by the State. As mentioned on the State's website, subscribers will have the opportunity to change their assigned plan if it falls out of network with the subscriber's chosen providers.
As participants begin to review their options, SampsonRMC offers the below tips when selecting their plan.
To follow updates made on managed care contracts signed by SampsonRMC visit, www.SampsonRMC.org/Medicaid.
For additional help on selecting a plan that best fits your needs, you may contact the State's Medicaid Contact Center at 1.888.245.0179 or online at Medicaid.ncdhhs.gov/transformation.