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How to Access PIHP Services

‘We are members’ - Partners NC Medicaid Direct Plan
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NC Medicaid Direct is North Carolina’s health care program for Medicaid beneficiaries who are not enrolled in NC Managed Care Standard or Tailored health plans. Partners has a group of health care providers (doctors, therapists, specialists, hospitals and other health care facilities) that make up our provider network.

You can visit our website at and click on Find a Provider at the top of the page to see our provider directory for NC Medicaid Direct and Tailored Plan. You may also call our Member and Recipient Services Line at 1-888-235-4673 (TTY: 711; 1-800-735-2962 for English or 1-888-825-6570 for Spanish) to get a copy of the provider directory.

Some services require approval before you can receive or continue them. In most cases, your provider will submit a request, called a prior authorization, to get approval to provide those services to you. If you have questions about starting or continuing a service, call our Member and Recipient Services Line at 1-888-235-4673.

NC Medicaid Direct includes:

  • Physical health services, like regular checkups, maternity care, hospital care, vision care, pharmacy and nursing home services provided by an NC Medicaid Direct provider.
  • Services for mental health, substance use disorders, intellectual/developmental disabilities (I/DD) or traumatic brain injuries are provided by a Local Management Entity/Managed Care Organization (LME/MCO) like Partners.
  • Care management is provided by Community Care of North Carolina (CCNC) or by Partners.

Partners works closely with the rest of the NC Medicaid Direct Program, including services provided by CCNC, Community Alternatives for Children (CAP/C) and Community Alternatives for Disabled Adults (CAP/D). We have a lot of experience helping people who may need services for behavioral health, I/DD and/or TBI care to stay healthy. Partners offers:

  • Medicaid-covered behavioral health, I/DD and TBI services
  • Intermediate care facilities for individuals with intellectual disabilities (ICF-IID) services (for people who qualify)
  • NC Innovations Waiver services (for people who qualify)
  • Care management (for people who qualify) to help make sure you get the care that you need, including additional care beyond medical needs (such as help with housing and food assistance). You may also qualify for care management provided by CCNC.