Carolina Complete Health Login, Coverage & Help

Carolina Complete Health is a North Carolina Medicaid managed care plan offering comprehensive health coverage and extra member support. In this guide, we cover how to log in to your Carolina Complete Health member portal, explore the coverage benefits, find doctors and pharmacies, get your health plan ID card, and access help when you need it. Whether you’re a new enrollee applying for Carolina Complete Health or an existing member looking for assistance, we’ve got you covered. Read on for details on benefits, providers, customer support, and common FAQs.

What Is Carolina Complete Health?

Carolina Complete Health is a Medicaid health plan serving families and individuals across North Carolina. As a member, you receive Medicaid coverage through a network of doctors and providers. The plan is part of Centene’s network of Medicaid plans and includes extra programs to support your well-being. Carolina Complete Health’s Medicaid plan is designed to cover preventive care, routine doctor visits, prescription drugs, and more – all tailored to meet NC Medicaid requirements.

According to the official site, “Your Carolina Complete Health plan offers Medicaid benefits and services. It also includes valuable programs, educational tools, and support.”. In practice, this means you have access to regular check-ups, specialist referrals, prescriptions, and many other services with little or no cost share. By choosing Carolina Complete Health, you join a network of providers who understand Medicaid and coordinate care for you and your family.

Carolina Complete Health Coverage and Benefits

Carolina Complete Health provides comprehensive coverage for a wide range of health needs. Key benefits include:

• Regular and Preventive Care: This includes routine check-ups, immunizations, well-child visits, and screenings. For example, the plan covers annual check-ups, blood pressure tests, cancer screenings (mammography, cervical, colorectal), developmental and diabetes screenings, and more. Children under 21 receive Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services for growth and development.
• Primary and Specialty Care: You can see a Primary Care Provider (PCP) for day-to-day healthcare. You also have referrals to specialists when needed. Specialty care covered includes respiratory therapy, podiatry, chiropractic care, cardiology, surgical services, and other doctor specialties.
• Hospital and Emergency Services: Inpatient and outpatient hospital care (including surgery, labs, and imaging) are covered. Emergency room treatment is covered in true emergencies to stabilize you. After emergency care, follow-up services are also covered to keep you healthy.
• Maternity and Newborn Care: Pregnancy and childbirth services, including prenatal visits, childbirth education classes, delivery, and medically necessary postpartum newborn care, are covered. High-risk pregnancies receive additional care management up to two months after delivery.
• Behavioral Health Services: Mental health and substance use disorder services are included. All members have access to counseling, therapy (individual, group, family), crisis intervention, outpatient behavioral health, and inpatient treatment for mental health or substance issues. If you need more intensive psychiatric services not in the basic plan, you can contact your PCP or Member Services for help (see Contact Info below).
• Family Planning: You can obtain birth control, IUDs, implants, and other family planning services from any Medicaid provider—no referral needed.

Figure: A doctor working with a patient via an online portal – reflecting how Carolina Complete Health doctors and members use the secure member account.

• Pharmacy and Medications: Prescription drugs are covered, including brand-name and generic medications. The plan also covers certain over-the-counter (OTC) medicines (like allergy relief), insulin and diabetic supplies, smoking cessation aids (including over-the-counter nicotine patches/gum), enteral formula for children on tube feeding, emergency contraception, and necessary medical/surgical supplies. Carolina Complete Health maintains a Preferred Drug List (PDL) – a formulary of covered medications – which is available online. (If your medicine isn’t on the PDL, you can ask your doctor about a covered alternative or a prior authorization.)
• Additional Member Services: Beyond standard Medicaid benefits, Carolina Complete Health offers Value-Added Services to support wellness, such as health education, reward programs, and community events. The plan emphasizes that “true health goes beyond the doctor’s office,” providing extra services like transportation assistance, baby showers for expectant moms, and health workshops to help members stay healthy.

In summary, Carolina Complete Health’s Medicaid plan covers preventive care, doctor and hospital services, prescriptions, and more. The plan follows North Carolina Medicaid rules but can also cover certain additional services not usually covered (called “In Lieu of Services” when medically necessary). For a full list of covered services, members should consult the Carolina Complete Health Member Handbook or Benefits Summary on the website.

How to Apply for Carolina Complete Health

If you’re eligible for Medicaid in North Carolina, you can choose Carolina Complete Health as your health plan. To apply for Medicaid and enroll in Carolina Complete Health, follow these steps:

1. Apply for NC Medicaid: First, apply to the North Carolina Medicaid program if you haven’t already. You can apply online at the NC Medicaid enrollment site: www.ncmedicaidplans.gov/enroll:contentReference[oaicite:22]{index=22}. The online process is available 24/7. You can also apply by phone at 1-833-870-5500 (TTY 711) or by mailing/faxing a form as described on the site. NC Medicaid covers children, pregnant women, families, seniors, and people with disabilities.
2. Enroll in a Health Plan: Once your Medicaid application is approved or if you need to choose a plan, select Carolina Complete Health as your managed care plan. The NC Medicaid website (or their phone line at 1-833-870-5500) provides information on all available plans. Carolina Complete Health’s website notes: “You can apply for Medicaid services and enroll in a health plan in several ways: Online at ncmedicaidplans.gov.”
3. Complete the Enrollment: After choosing Carolina Complete Health, complete any required paperwork. You may need to sign up through the NC Medicaid portal or return an enrollment form. If you receive a mailer form, you can fax it to 1-833-898-9655 or send by mail to NC Medicaid PO Box 613, Morrisville NC 27560.
4. Choose a Primary Care Provider (PCP): You will be asked to pick a PCP/doctor as your main healthcare provider. You can change your PCP anytime later. The online member portal (see below) allows you to select or change your PCP easily.
5. Look for Welcome Information: After enrollment, Carolina Complete Health will send you a welcome packet in the mail. This includes your Member ID card and plan materials. Keep an eye out for this mailer and the ID card, which you’ll use at doctor visits and pharmacies.

For assistance with enrollment, an independent enrollment broker is available: call 1-833-870-5500 (TTY: 1-833-870-5588) for free help choosing the right plan. Remember, Carolina Complete Health is only available through the state Medicaid program; you don’t apply directly to the plan. Always ensure your Medicaid application is approved and the plan is activated.

Finding Doctors and Providers

Once you’re a member, Carolina Complete Health makes it easy to find doctors, specialists, hospitals, and other providers in your network. You have access to a wide network of contracted providers across North Carolina. Key points:

• Primary Care Providers (PCP): When you joined the plan, you selected a PCP (family doctor or pediatrician). Your PCP coordinates your care. You can schedule regular check-ups, discuss any health issue, and get referrals.
• Online Provider Directory: Carolina Complete Health offers an online Find a Provider search tool. Using this directory, you can look up doctors, hospitals, pharmacies, and more that accept your plan. Search by location, provider name, or specialty. The site explains: “You can view the doctors and other providers available to you on our online directory.”. This ensures you choose in-network providers for full benefits.
• Changing Your Provider: If you need to change your PCP or any doctor, you can do so at any time. Simply use your secure online account (member portal) or call Member Services. The member portal “allows you to change your Primary Care Provider” easily.
• Specialists: If you need specialized care (e.g. cardiologist, dermatologist, etc.), your PCP will refer you to a specialist in network. You can also search for specialists directly through the provider directory.
• Urgent Care and Emergency: For non-life-threatening issues outside of normal doctor hours, use in-network urgent care centers. For true emergencies (chest pain, stroke symptoms, severe trauma), go to the nearest ER or call 911 – Carolinа Complete Health covers emergency care. After the ER, follow up with your PCP as directed.

By using the Find a Provider tool and your online portal, you can ensure your medical care is in-network. This helps avoid out-of-pocket costs. If you have trouble finding a provider or need assistance, Carolina Complete Health’s Member Services can help refer you to nearby doctors.

Pharmacy Benefits (Carolina Complete Health Pharmacy)

Carolina Complete Health’s pharmacy benefit ensures you have access to necessary medications. Highlights:

• Prescription Coverage: All medically necessary prescription drugs are covered. You can use any pharmacy that accepts Carolina Complete Health Medicaid plans. Simply present your member ID card and pay any required co-pay.
• Preferred Drug List (PDL): To manage costs, Carolina Complete Health has a Preferred Drug List of covered medications. Drugs on this list are generally covered with minimal restrictions. If your medication is off the list, your doctor can request a prior authorization if it’s medically needed. The official site notes that the Preferred Drug List lists medications that are covered. Always check the PDL (available in the Member Materials section) or contact Member Services to verify coverage.
• Over-the-Counter Medicines: Some OTC medicines are covered with a prescription. For example, certain allergy medicines or smoking cessation products. Your doctor can write a prescription for these OTC products, and the plan will cover them as they do for prescriptions.
• Special Supplies: Carolina Complete Health covers diabetic supplies (insulin, test strips, syringes) and medical supplies (bandages, etc.) as prescribed. It also covers enteral nutrition (liquid formula for tube feeding) for children, and emergency contraception.
• Pharmacy Help: If you have questions about which drugs are covered or need to find a pharmacy, call Member Services (see below) or check the website. There is also a 24/7 Nurse Advice Line at 1-833-552-3876 for urgent medication questions.

In short, Carolina Complete Health Pharmacy benefits cover most medications you need. Always carry your ID card to the pharmacy. If you ever get an unexpected bill for a covered drug, call Member Services immediately.

Using Your Carolina Complete Health Card & Portal

Once you’re enrolled, you will receive a Carolina Complete Health ID card in the mail. This card proves your membership and should be presented whenever you see a doctor or fill a prescription. Keep it safe; you can use it at any covered provider. The card includes your name, member ID, and the plan’s important contact information.

• Lost or New ID Cards: If you lose your card, or if a dependent needs one, Member Services can issue a new card. As the Contact Us page notes, Member Services “can help with: … Getting your ID card”. Just call 1-833-552-3876 (TTY 711) to request a replacement card. Cards typically arrive by mail within a week or two.
• Member Portal (Online Account): The easiest way to manage your account is through the secure online member portal. To access it, go to the Carolina Complete Health website and click Member Portal Login. If you haven’t registered yet, you can create an account online. Once logged in, you can:
  • View claims, payments, and benefits.
  • See a digital copy of your ID card and print it if needed.
  • Change your personal information or address.
  • Choose or change your Primary Care Provider.
  • Complete health surveys and forms (like a Pregnancy Notification).
  • Access health resources (handbooks, preventive care tips, etc.).
  As the site encourages, “Create an online account … You will have access to your health care information. View claims, get a new ID card, update your information, and more!”. The portal is user-friendly and mobile-friendly – you can also download the Carolina Complete Health mobile app on iPhone or Android to stay connected on the go.
• Password/Login Issues: If you have trouble logging in (forgot password or username), use the “Forgot Password” link on the login page or call Member Services for assistance. Keep your login credentials confidential, and log out when done.

Using the ID card and online portal effectively puts you in control of your health plan. Many tasks are easy to do online, reducing wait times on the phone.

Contacting Carolina Complete Health (Phone & Support)

Need help? Carolina Complete Health offers multiple support lines:

• Member Services Hotline (Primary): For general questions about benefits, claims, or using your plan, call 1-833-552-3876 (TTY 711). This is the main number for members, available Monday–Saturday from 7 AM to 6 PM Eastern Time. The staff can assist with: your benefits and covered services, finding in-network doctors, choosing or changing your PCP, requesting a new ID card, or any plan-related questions.
• 24/7 Nurse Advice Line: Also at 1-833-552-3876 (TTY 711), the nurse line is staffed around the clock. Nurses are available 24/7 to answer health questions like symptoms you or a child are having, medication concerns, or where to seek care. This free service can help you decide if you need urgent care or can manage at home, and can provide guidance when your doctor’s office is closed.
• Behavioral Health Crisis Line: If you or a family member is experiencing a mental health crisis, call 1-855-798-7093, 24 hours a day. Trained counselors can talk you through the crisis and help find support. (If it’s a life-threatening emergency, call 911 immediately.)
• Medicaid Managed Care Ombudsman: If you have complaints or unresolved issues with your plan, the NC Medicaid Ombudsman can help independently. They can be reached at 1-877-201-3750 or via their website. They assist members in understanding rights and navigating problems with Medicaid plans.
• Office Locations: Carolina Complete Health has offices in Charlotte and Durham (addresses listed on their site). However, in-person visits are by appointment only, so call ahead if needed.

Tip: When you call, have your member ID number ready (from your ID card). The representative can usually look up your account quickly and answer questions.

Always keep a record of your Member Services calls, and feel free to ask for a supervisor if you need extra help. The plan is committed to assisting members – don’t hesitate to reach out with any coverage or benefit questions.

Figure: Doctors in surgery (highlighting the extensive hospital and specialty care covered under Carolina Complete Health).

Carolina Complete Health Reviews and Ratings

Searching for “Carolina Complete Health reviews” online may turn up a mix of information. Many of the user-generated reviews on job sites (like Indeed or Glassdoor) are from employees rather than members. For example, Carolina Complete Health Network, Inc. has a 3.4 out of 5 star rating on Indeed based on employee feedback. These ratings reflect workplace culture rather than patient care. As one Indeed review bluntly said, “Working at Carolina Complete Health Network, Inc: 7 Reviews” shows mixed employee opinions. It’s best to interpret these cautiously if you’re looking for plan quality.

On the other hand, official ratings of the plan’s performance are maintained by NC Medicaid. The state publishes an annual Plan Performance Comparison Tool (available on ncmedicaidplans.gov) showing how each health plan scored in areas like getting needed care, satisfaction, and health outcomes. For 2024/2025, Carolina Complete Health’s ratings are close to the state average. Specific star ratings (out of 5) for “Overall Rating of Health Plan” were generally around 3–3.5 stars for both child and adult members on surveys. The tool indicates Carolina Complete Health performs comparably to other NC Medicaid plans.

In summary, public reviews of Carolina Complete Health are limited. Prospective members should focus more on factual resources: verify that providers you need are in-network (using the provider directory), understand covered benefits (via official plan documents), and use state resources (like the Medicaid Plan Performance site) to compare plans if needed. If you have personal experiences with the plan, sharing your feedback through official surveys or with the state Medicaid office can help improve services.

FAQs about Carolina Complete Health

• Q: How do I access the Carolina Complete Health member portal?
  A: Visit the official site and click on “Member Portal Login” (top menu). Then create an account if you haven’t yet. The portal allows you to log in with your email/username and password to view benefits and manage your plan.
• Q: What does Carolina Complete Health cover?
  A: As a Medicaid plan, Carolina Complete Health covers services required by NC Medicaid: preventive care, doctor visits, hospital stays, emergency care, prescriptions, behavioral health, and more. It also offers extra programs (Value-Added Services) like healthy baby classes and a reward program. Always check the Member Handbook or benefits summary for specifics on coverage.
• Q: How do I find doctors in Carolina Complete Health’s network?
  A: Use the Find a Provider online search tool on their site. You can search by location, specialty, or doctor name. The website notes “You can view the doctors and other providers available to you on our online directory”. You can also call Member Services for help finding a local PCP or specialist.
• Q: Can I change my Primary Care Provider (PCP)?
  A: Yes. Log into your member portal and select “Change My PCP,” or call Member Services at 1-833-552-3876 and ask to change your doctor.
• Q: How do I apply for Carolina Complete Health if I’m eligible for Medicaid?
  A: Apply through the NC Medicaid system. Go to www.ncmedicaidplans.gov/enroll and fill out the application. After approval, choose Carolina Complete Health as your plan. You can also call 1-833-870-5500 (TTY 711) to apply or ask questions.
• Q: What is Carolina Complete Health’s phone number?
  A: The main Member Services phone number is 1-833-552-3876 (TTY 711), available Monday–Saturday 7 AM–6 PM. This number handles most member inquiries. The Nurse Advice Line (same number) is available 24/7 for medical advice.
• Q: Does Carolina Complete Health cover prescription drugs?
  A: Yes. Most prescriptions are covered. The plan has a preferred drug list; if your medication isn’t listed, your doctor can request prior authorization. The plan covers diabetic supplies, vaccines, and some OTC drugs (with prescription). Check with your pharmacy if you have questions, or call Member Services.
• Q: How do I use my Carolina Complete Health card?
  A: Show your ID card at each medical or pharmacy visit. It has your name and member ID. If you get a bill or charge, you should not pay – call Member Services right away. If you lose your card, Member Services can send a replacement.
• Q: Where can I find the Carolina Complete Health provider list?
  A: The provider directory (findaprovider.carolinacompletehealth.com) lists all in-network doctors, specialists, pharmacies, and facilities. You can search it on the website or through the member portal.
• Q: How do I enroll in Carolina Complete Health?
  A: You enroll by applying for NC Medicaid and selecting Carolina Complete Health as your plan. See [How to Enroll in Medicaid] for details.
• Q: What if I need help with languages or accommodations?
  A: Carolina Complete Health provides free translation services and materials in other formats (Braille, large print) at no cost. Call 1-833-552-3876 (TTY 711) to request assistance.

These FAQs are designed to address common member questions. If you have more, you can contact Member Services or check the Frequently Asked Questions section on the Carolina Complete Health website.

Conclusion

Carolina Complete Health provides robust Medicaid coverage and supportive services for members in North Carolina. By understanding your benefits, knowing how to apply, and using available resources, you can make the most of your plan. Don’t forget to use the Carolina Complete Health login portal to manage your account online. Keep your member ID card handy, and reach out to Member Services at 1-833-552-3876 whenever you need help with coverage, providers, or prescriptions.

We hope this guide helps you navigate Carolina Complete Health coverage and support. If you found this information useful, consider sharing it with other members or on social media. And feel free to leave a comment or question below – we’re here to help. Your health is our priority, and Carolina Complete Health is here to ensure you get the care you need.

Sources: Official Carolina Complete Health website and North Carolina Medicaid resources. Each citation corresponds to the latest available information as of 2025.