Ombudsman Program

The NC Medicaid Ombudsman is an independent organization that helps NC Medicaid and NC Health Choice beneficiaries understand the Medicaid and NC Health Choice programs and ensures that they get access to the care that they need. They help connect people to resources like legal aid, social services, housing resources, food assistance and other programs, and provide free, confidential support and education about the rights and responsibilities people have under NC Medicaid.

The NC Medicaid Ombudsman can:

  • Help you get the care that you need
  • Answer your questions about benefits
  • Help you understand your rights and responsibilities
  • Provide information about NC Medicaid Managed Care and NC Health Choice
  • Answer your questions about enrolling with or disenrolling from a health plan
  • Help you understand a notice you have received
  • Refer you to other agencies that may be able to help you with your health care needs
  • Help with issues you have been unable to resolve with your health care provider or health plan
  • Be an advocate for members dealing with an issue or a complaint affecting access to health care
  • Tell NCDHHS about issues with NC Medicaid so that they can find solutions
  • Provide information to help you with your appeal, grievance, mediation, or fair hearing
  • Connect you to legal help if you need it to help resolve a problem with your health care
  • Ensure that your voice is heard and that you get access to high quality health care

You can call the NC Medicaid Ombudsman at 1-877-201-3750 from 8 a.m. to 5 p.m., Monday through Friday except for state holidays. Learn more at ncmedicaidombudsman.org.