Confirming Medicaid Coverage for Beneficiaries

NC Medicaid has received reports of confusion in the field by providers and pharmacies when members do not present an ID card or when presented with a Medicaid member ID card that differs from the data shown in the NCTracks system. 

To mitigate any confusion associated with newly issued Medicaid Managed Care member ID cards, providers and pharmacies should always use NCTracks Recipient Eligibility Verification/Response to confirm eligibility and not rely solely on the information shown on a Member ID Card. 

Health plans are required to generate an identification card for each Member enrolled in their health plan that contains the Member’s North Carolina Medicaid or NC Health Choice Identification number. Some health plans also include their health plan member ID as well. However, member ID cards are not required to provide service, and this includes pharmacies as well. Therefore, members should not be turned away due to the lack of a Member ID card in their possession.

For more information, please see the Medicaid bulletin Confirming Medicaid Coverage for Beneficiaries.

Search EBCI Tribal Option