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Health Plans for North Carolina.

At this time, the Medicare Advantage Plans available are for senior citizens and people with special needs and medical conditions who qualify for both Medicaid and Medicare Parts A and B.

We offer 4 health plans in North Carolina

Enter a 5-digit ZIP code, 2-letter state abbreviation or full state name.

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  • 2

    Dual Eligible Plans
    (Medicare - Medicaid)

    View Plans | Check Eligibility

    Dual Eligible Plans <br> (Medicare - Medicaid)

    You might qualify for Dual Eligible Plans if...

    • You are under age 65, eligible for state Medicaid benefits, and qualify on the basis of disability or other special situation.
    • You are at least 65 years old and receive Extra Help or assistance from your state.
    View Dual Eligible Plans
    (Medicare - Medicaid)

  • 1

    Medicaid Plans

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    Medicaid Plans

  • 1

    Individual & Family Plans
    (Exchange)

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    Individual & Family Plans <br> (Exchange)

    You might qualify for Individual & Family Plans if...

    To be eligible you must live in the US, be a US citizen or national and cannot be incarcerated. However, if you qualify for Medicare or Medicaid - those options may be a better fit for you. And if you have insurance options through your employer, it's really up to you to decide between that coverage or the plans offered on the Exchange.

    View Individual & Family Plans
    (Exchange)

You might qualify for Dual Eligible Plans if...

  • You are under age 65, eligible for state Medicaid benefits, and qualify on the basis of disability or other special situation.
  • You are at least 65 years old and receive Extra Help or assistance from your state.
View Dual Eligible Plans
(Medicare - Medicaid)

You might qualify for Individual & Family Plans if...

To be eligible you must live in the US, be a US citizen or national and cannot be incarcerated. However, if you qualify for Medicare or Medicaid - those options may be a better fit for you. And if you have insurance options through your employer, it's really up to you to decide between that coverage or the plans offered on the Exchange.

View Individual & Family Plans
(Exchange)

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UnitedHealthcare Dual Complete® (HMO-POS D-SNP)

H5253-041-000

Monthly Premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility.

This dual health plan is for people who qualify for both Medicaid and Medicare Parts A & B (Original Medicare).

This is a Health Maintenance Organization (HMO) plan. With an HMO plan, you must use network providers to get your medical care and services. 

Alamance, Buncombe, Caswell, Catawba, Chatham, Cumberland, Davidson, Davie, Durham, Forsyth, Guilford, Henderson, Mecklenburg, Orange, Person, Randolph, Rockingham, Rowan, Stokes, Wake, Wilkes, and Yadkin.

View Plan Details Enroll in Plan (opens modal window)

Benefits & Features

  • Dental

    Up to $3500 for covered types of preventive and comprehensive dental services

  • OTC Items - Debit and Food Allowance

    Up to $1,200 per year to buy OTC products, plus $660 per year for healthy foods

  • Vision

    Routine eye exam and $300 allowance toward eyewear

View Plan Details Enroll in Plan (opens modal window)

Have questions?    8 a.m. – 8 p.m. local time, 7 days a week    1-844-812-5967    TTY 711

UnitedHealthcare Dual Complete® RP (Regional PPO D-SNP)

R1548-001-000

Monthly Premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility. 

This dual health plan is for people who qualify for both Medicaid and Medicare Parts A & B (Original Medicare).

This is a Preferred Provider Organization (PPO) plan. You have access to a local network of doctors and hospitals. Plus, you can see any provider outside the network nationwide that participates in Medicare and accepts the plan. You may pay a higher copay or coinsurance when you see an out-of-network provider.

Accomack, Alamance, Albemarle, Alexander, Alexandria City, Alleghany, Amelia, Amherst, Anson, Appomattox, Arlington, Ashe, Augusta, Avery, Bath, Beaufort, Bedford, Bertie, Bladen, Bland, Botetourt, Bristol City, Brunswick, Buchanan, Buckingham, Buena Vista City, Buncombe, Burke, Cabarrus, Caldwell, Camden, Campbell, Caroline, Carroll, Carteret, Caswell, Catawba, Charles City, Charlotte, Charlottesville City, Chatham, Cherokee, Chesapeake City, Chesterfield, Chowan, Clarke, Clay, Cleveland, Colonial Heights City, Columbus, Covington City, Craig, Craven, Culpeper, Cumberland, Currituck, Danville City, Dare, Davidson, Davie, Dickenson, Dinwiddie, Duplin, Durham, Edgecombe, Emporia City, Essex, Fairfax, Fairfax City, Falls Church City, Fauquier, Floyd, Fluvanna, Forsyth, Franklin, Franklin City, Frederick, Fredericksburg City, Galax City, Gaston, Gates, Giles, Gloucester, Goochland, Graham, Granville, Grayson, Greene, Greensville, Guilford, Halifax, Hampton City, Hanover, Harnett, Harrisonburg City, Haywood, Henderson, Henrico, Henry, Hertford, Highland, Hoke, Hopewell City, Hyde, Iredell, Isle of Wight, Jackson, James City, Johnston, Jones, King And Queen, King George, King William, Lancaster, Lee, Lenoir, Lexington City, Lincoln, Loudoun, Louisa, Lunenburg, Lynchburg City, Macon, Madison, Manassas City, Manassas Park City, Martin, Martinsville City, Mathews, McDowell, Mecklenburg, Middlesex, Mitchell, Montgomery, Moore, Nash, Nelson, New Hanover, New Kent, Newport News City, Norfolk City, Northampton, Northumberland, Norton City, Nottoway, Onslow, Orange, Page, Pamlico, Pasquotank, Patrick, Pender, Perquimans, Person, Petersburg City, Pitt, Pittsylvania, Polk, Poquoson City, Portsmouth City, Powhatan, Prince Edward, Prince George, Prince William, Pulaski, Radford City, Randolph, Rappahannock, Richmond, Richmond City, Roanoke, Roanoke City, Robeson, Rockbridge, Rockingham, Rowan, Russell, Rutherford, Salem City, Sampson, Scotland, Scott, Shenandoah, Smyth, Southampton, Spotsylvania, Stafford, Stanly, Staunton City, Stokes, Suffolk City, Surry, Sussex, Swain, Tazewell, Transylvania, Tyrrell, Union, Vance, Virginia Beach City, Wake, Warren, Washington, Watauga, Wayne, Waynesboro City, Westmoreland, Wilkes, Williamsburg City, Wilson, Winchester City, Wise, Wythe, Yadkin, Yancey, and York.

View Plan Details Enroll in Plan (opens modal window)

Benefits & Features

  • Dental

    Up to $2500 for covered types of preventive and comprehensive dental services

  • Prescription Drug Coverage

    $0 drug copays on all tiers of covered medications with option for home delivery

  • OTC Items - Debit and Food Allowance

    Up to $1,220 per year to buy OTC products, plus $660 per year for healthy foods

View Plan Details Enroll in Plan (opens modal window)

Have questions?    8 a.m. – 8 p.m. local time, 7 days a week    1-844-812-5967    TTY 711

UnitedHealthcare Community Plan Medicaid

UnitedHealthcare Community Plan of North Carolina provides Medicaid coverage to children, pregnant women, families and adults. You can choose your own doctor, and get many extras that other plans don’t offer.

This plan is available in all counties.

View Plan Details

Benefits & Features

  • Choice of Doctor

    Use Doctor Lookup tool to see if your doctor is in our network or to find a new one.

  • Medicines

    Fill your prescriptions at local pharmacies.

  • Transportation

    We pay for rides to and from medical visits.

View Plan Details

Have questions?    Monday - Friday 8am – 5pm ET Excluding State Holidays 1-800-349-1855    TTY 711

 

Balance and Value

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.  

Alexander, Bladen, Brunswick, Buncombe, Burke, Caldwell, Catawba, Columbus, Cumberland, Duplin, Franklin, Guilford, Harnett, Haywood, Henderson, Hoke, Iredell, Jackson, Johnston, McDowell, New Hanover, Orange, Pender, Randolph, Richmond, Robeson, Rockingham, Rutherford, Sampson, Scotland, Transylvania, and Wake.

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Benefits & Features

  • 3 $0 virtual visits

    Get the urgent care you need in 15 minutes or less, usually, with three virtual visits at no cost to you.

  • $0 preventive care

    Don't pay more for preventive care. These plans offer it at no additional cost.

  • Low-cost prescriptions

    Save money with $0 co-pays on preventive drugs and the ability to get your prescriptions conveniently at many locations, including Walgreens and Walmart.

View Plan Details (Opens in a New Tab)

Have Questions? 1-888-610-9045 TTY 711

Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete 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 plan’s 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 1-800-905-8671 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.

Nurseline Disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your doctor's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time.

UnitedHealthcare Connected™ for MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan) information, please contact our Member Services at 1-844-445-8328 (TTY 711) from 7 a.m. to 8 p.m. Monday through Friday (voice mail available 24 hours a day/7 days a week) for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare® Connected™ de MyCare Ohio (plan Medicare-Medicaid), comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al 1-844-445-8328 (TTY 711) de lunes a viernes de 7 a.m. a 8 p.m. (correo de voz disponible las 24 horas del día, los 7 días de la semana).

UnitedHealthcare Connected™ (Medicare-Medicaid Plan)

UnitedHealthcare Connected (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected Benefit Disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year.

UnitedHealthcare Senior Care Options (HMO SNP) Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Availability of Non-English Disclaimer

ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call 1-800-905-8671 TTY 711.

ATENCIÓN: Si habla [ingrese el idioma], hay servicios de asistencia lingüística disponibles para usted y que no tienen cargo. Llame al 1-800-905-8671 TTY 711.

Star Ratings Disclaimer

Medicare evaluates plans based on a 5-Star rating system.

Formularies

The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

NCQA

UnitedHealthcare Connected has a Model of Care approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2017 based on a review of UnitedHealthcare Connected’s Model of Care.

Important Provider Information

The Choice is Yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non- contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

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 ("ADA"), 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.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper Directory Requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate Information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UHC Members should call the number on the back of their ID card, and non-UHC members can call 888-638-6613 TTY 711.

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Last Updated: 12.16.2020 at 12:57 PM CST

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