Member resources
Access helpful materials to learn more about Healthy Blue Care Together.
Department of Social Services (DSS) resources
The local DSS focuses on promoting self-reliance and preventing abuse, neglect, dependency and exploitation among vulnerable individuals, children and families.
Determine your eligibility
Eligibility for Medicaid and other assistance programs is determined by the local DSS. Each local DSS plays a key role in serving children and families. They do this by:
- Providing services to children in need
- Licensing foster homes
- Working to reunite children with their families
Please call your local DSS or use the DSS directory to check if you are eligible.
Our collaborative approach
DSS and Healthy Blue Care Together work together to find the right teams, programs and services to help those children, youth or young adults currently or formerly served by child welfare that are at risk or in need of help access comprehensive treatment, supervision, structure, placement and support.
Pharmacy and prescription drug benefits
Your benefits include a wide range of prescription and over-the-counter (OTC) medicines. You can even have your medicines delivered to your home. We work with CarelonRx to provide these benefits.
- The Preferred Drug List (PDL) is the list of drugs that your doctor will use first when prescribing you medicine. These drugs have been chosen for their quality and effectiveness. Your doctor can prescribe most of these medicines to you without getting preauthorization, or an "OK," from us. The PDL is updated frequently.
- The searchable formulary is a list of all brand-name and generic drugs available in your plan. It lists all the drugs found on the PDL, plus others. All drugs on the formulary are covered, but many require preauthorization before the prescription can be filled.
NC CarePoints Connect
NC CarePoints Connect is a secure and free web-based application. It offers tools and resources to improve health outcomes and allows members to redeem their extra benefits and healthy rewards. NC CarePoints Connect helps share vital information, such as medical records, screenings, medicines, trauma assessments and care plans. Users access it by selecting "Register with NC CarePoints Connect" and completing the short registration process.
Go tobacco-free
Have you ever thought about quitting smoking, vaping, chewing or dipping? How much healthier would you be? How much money would you save? Making a change can be hard, but you can do it! To learn more about quitting visit Quit Now or call 866-784-8454 (TTY 711).
Judicial program
Our new judicial program is designed to help kids and families who are involved with the courts and justice system. This program aims to strengthen families, provide extra support, and cut down on the number of youth revolving in and out of foster care. We will do this by:
- Providing positive ways for young people and families to get help from the justice system
- Supporting individuals as they leave the juvenile justice system
- Helping to reduce the chances of them getting into trouble again
For more information, you can reach out to Keith Cradle, HBCT Judicial Program Director at Keith.Cradle@bcbsnc.com.
System of Care (SOC)
The SOC approach works to improve behavioral health outcomes for children and families. Systems work together to intervene early and hold themselves accountable. This helps keep children safer and families more stable. It also helps prevent child abuse and neglect.
Healthy Blue Care Together uses the SOC model to create a support network for children, youth and families. This lets members and their natural support systems:
- Set treatment goals
- Choose from various community-based services
The SOC model involves working with:
- Schools
- The juvenile justice system
- Child welfare agencies
- Providers
- Communities
For more information about SOC, please refer to your member handbook.
SOC contacts and resources
You can learn more about SOC by reading the Healthy Blue Care Together member handbook or visiting the links to our trusted partners.
Families may also reach out to the NC SOC Team at the Division of Child and Family Well-Being (DCFW). This team has a contact list of all local SOC Collaboratives in North Carolina.
Kindred Village
Kindred Village helps support caregivers. It seeks to empower and teach kinship, adoptive, foster and biological parents. Its mission is to ensure every child thrives in a permanent, safe and loving home.
Kindred Village works with leading foster care and permanency provider agencies in North Carolina to help more youth reach permanent homes faster. It works to strengthen and expand effective, existing programs. Investing in what’s already working helps create an easier path for reunification, kinship placement and adoption.
Kindred Village partners with permanency provider agencies to help allow more people to take part in kinship and foster care. That helps more families provide stable, nurturing and permanent homes for children and youth.
Statewide and regional trainings
Wherever you are located in North Carolina, we have training opportunities for you and your family. These topics help promote social, physical and mental health for our Healthy Blue Care Together members.
Webinars, trainings, and on-demand learning
Explore learning opportunities from our trusted partners.
Trainings and webinars | Foster Family Alliance of North Carolina
Trauma-informed trainings and resources | Creating A Family
Ombudsman support
The NC Medicaid Ombudsman is a resource you can use when you have been unable to resolve issues with Healthy Blue Care Together or doctors. It is an independently operated, nonprofit organization. The NC Medicaid Ombudsman:
- Resolves issues
- Provides education and advocacy
- Ensures individuals and families under NC Medicaid Managed Care get access to the care they need
To contact the NC Medicaid Ombudsman, please call 877-201-3750 or visit https://ncmedicaidombudsman.org/.
Appeals, grievances, and State Fair Hearing policies
As a Healthy Blue Care Together member, you have the right to ask us to reconsider decisions we have made and to make complaints. These are called appeals and grievances. If you would like support in filing an appeal and/or grievance, please contact Member Services at 833-777-3611 (TTY 711).
Once filed, we have 30 days to get back to your appeal. You may also ask for an appeal by:
- Mail: Fill out the appeal request form in the notice you receive about our decision
- Fax: Fill out, sign and fax the appeal request form in the notice you received about our decision
- Phone: Call 833-777-3611 (TTY 711) and ask for an appeal
You may ask for a State Fair Hearing by:
- Mail: Fill out and sign the State Fair Hearing request form that comes with your notice
- Fax: Fill out, sign and fax the State Fair Hearing request form that comes with your notice
- Phone: Call NC Office of Administrative Hearing (OAH) at 1-984-236-1860 and ask for a State Fair Hearing
If you ever have a complaint (grievance) you can contact us by phone or mail.
- Call member services at 833-777-3611 (TTY 711) 7 a.m. – 6 p.m. Eastern Time (including state holidays)
- Mail your compliant to Healthy Blue Care Together – 1965 Ivy Creek Blvd, Durham, NC 27707
To learn more about appeals, grievances, and state fair hearings, check your member handbook.
Helpful resources
Explore more information on policies, enrollment, contact information and other useful materials.
Get a ride to your appointments
Accessing the care you need, when you need it, is an important part of staying healthy. As a member of Healthy Blue Care Together, you can receive free rides to and from your doctor’s office, pharmacy, and other providers of covered services. To learn more about Modivcare (third party vendor) and how to schedule your ride, download the Modivcare App or call Modivcare at 855-397-3615 anytime 24 hours a day, seven days a week. The Modivcare App makes it easy to book a ride for your doctor visit.
Healthy Blue Care Together can also arrange and pay for your transportation to help you/your child get to and from your appointments for Medicaid-covered care. If you need an attendant to go with you to your doctor's appointment, or if your child (age 18 or younger) is a member of the plan, transportation is also covered for the attendant or an accompanying passenger. Non-emergency transportation includes personal vehicles, taxis, vans, mini-buses, public transportation and stretchers.
Remember, if you need emergency transportation, call 911.
Healthy Blue Care Together Policies
Utilization Management Policy - coming soon