Explore the Enhanced Asthma/COPD Care Silver plan.

  

Members also have access to free health education.

Learn helpful tips on staying healthy: how to manage symptoms, safely take medications, eat well and stay active. 

You can explore interactive AI tools to learn more about asthma and COPD, along with tips for improving lung health.

Plus, explore more resources that support your mental and physical well-being, help you prevent illness, and guide you in making smart choices about your health: Explore Health and Wellness Resources.

Members enrolled in this plan may have access to the Wellframe® app to connect with a care manager, get reminders about medications and more. 

Download the app to get started: 

  1. Visit wellframe.com/download on your mobile device and download the app.
  2. Open the app and select “Sign Up.”
  3. Enter your access code: cncgroupdenweb.

Wellness and Rewards

New in your member account and mobile app!

Ambetter Health plans now include Wellness and Rewards—a new way to do more than just manage your coverage. Earn rewards, explore discounts, and get personalized support for your mind and body, all in one place. Log in to your online member account or mobile app today to explore this new feature.

After you enroll, you may be assigned a Primary Care Provider (PCP). Your PCP is your main health care professional and should be your first choice for:

  • Routine checkups 
  • Non-emergency medical care such as colds and fevers
  • Managing health conditions like allergies and asthma
  • Prescriptions
  • Lab tests 
  • Imaging services like x-rays, ultrasounds or CT scans 

You can view or change your PCP in your Online Member Account

The Enhanced Diabetes Care Silver plan offers Care Management services to support you in your health journey. Care Managers can work closely with you and your doctors to create a care plan based on your needs.

Our Care Managers are registered nurses or social workers who can:

  • Work with your providers to support your health goals
  • Help coordinate your care
  • Connect you with additional resources

Want extra support with your care? Visit our Care Management page to see how a Care Manager can help you reach your health goals and get the care you need.

Apart from specialized care, your plan offers balanced care for your whole health:

  • Preventive care benefits, such as annual wellness exams and vaccinations, at no extra cost to you
  • Psychotherapy and counseling
  • Inpatient care
  • and more! 

   

Getting Started

You can easily manage your healthcare and get the most out of the Enhanced Asthma/COPD Care Silver plan. Here are some useful things you can start with:


Download the Ambetter Health Mobile App

To access your health plan details on the go, download the Ambetter Health mobile app from the app page or search for “Ambetter Health” in your app store. To start using the app, sign in with your Online Member Account login and password. 

Your Ambetter Health app has all the useful features of the member account. Additionally, you can contact member support directly through the app, quickly open your digital ID Card in the app or save it to your device wallet.
 


Review Your Plan Documents

  • Member Welcome Packet. It includes your Member ID Card and helpful information about your plan and resources that are available. Your Welcome Packet is mailed to you after you make your first premium payment.
  • Digital ID Card. Access your digital ID Card anytime. You can view and download your digital ID Card in your Online Member Account 24–48 hours after your payment. You can also find it in the Ambetter Health mobile app. 
  • Evidence of Coverage (EOC). This is your “member contract”. In it you can find all the details about your Ambetter Health plan benefits and covered services. Log in to your Online Member Account and select “Email” under “Communication Preferences” to access this document digitally.

Explore Your Ambetter Health Network

Find doctors, pharmacies and health services in your area that meet your needs. Search for in-network care using the Find a Provider

  • Go to findaprovider.ambetterhealth.com.
  • Enter your City, County or ZIP Code.
  • Select the PREMIER network.
  • Search by Specialty, Facility/Group Name, Provider Name, or choose a category to begin your search.

Tip: Already a member? Log in to skip these steps and go straight to your plan's network.

Schedule your Wellness Check

View your PCP and schedule your first appointment right away. Your PCP will be your first choice when you need medical care. You can change your PCP but check to make sure that the PCP is in-network to avoid additional costs.

A wellness check normally includes:

  • A comprehensive history appropriate for your age and gender
  • Physical examination
  • Counseling or anticipatory guidance
  • Interventions to reduce risk factors
  • Ordering of appropriate immunizations, labs and screenings

Activate Your My Health Pays® Rewards

My Health Pays is a rewards program that pays you for the healthy decisions you’re already making every day.  

Benefits 

With your Enhanced Asthma/COPD Care Silver plan, you have access to all essential benefits and much more. Ambetter Health offers free health and wellness services, pharmacy home delivery, and access to exclusive discounts and rewards. 

Essential Benefits and So Much More

You are covered with Essential Benefits. All health plans offered on the Health Insurance Marketplace include certain items or services. They are known as Essential Health Benefits (EHBs). Ambetter Health covers you on these essential medical care and wellness services: 

  • Emergency Care
  • Outpatient or Ambulatory Care
  • Preventive & Wellness Care
  • Maternity & Newborn Care
  • Pediatric Care
  • Mental Health & Substance Abuse Care
  • Laboratory Services
  • Prescription Drugs
  • Therapy Services
  • Hospitalization

Where to go for care

With the Enhanced Asthma/COPD Care Silver plan, you have many options to support your physical and mental health. If your injury is minor and not life threatening, like a sprain or a cold, call your Primary Care Provider (PCP). If you can't wait for an appointment with your PCP, consider one of the options below. Have a question about your prescriptions, refills, over-the-counter medicine, or side effects? Your local pharmacist also can help you at no cost over the phone or in person.

   Virtual 24/7 Care**

Virtual 24/7 Care is a great option for urgent care around the clock. If you cannot get in with your PCP fast enough or it's after your PCP's hours, Ambetter Health's Virtual 24/7 Care is here to help. Use it whenever and wherever works best for you.

Before you start using Virtual 24/7 Care, set up your account at AmbetterTelehealthNC.com.

You can reach Virtual 24/7 Care providers by phone or video when you need medical care, a diagnosis or a prescription. Choose to receive immediate care or schedule an appointment for a time that fits in your schedule. 

Get help with:

  • Colds, flu and fevers
  • Rash and skin conditions
  • Respiratory infections, ear infections or pink eye
  • Stress, anxiety, depression or grief

   24/7 Nurse Advice Line

Our free nurse advice line makes it easy to get answers to your health questions. Staffed by licensed nurses, it runs 24 hours a day, 7 days a week. You don't even have to leave home! Call 1-833-863-1310 (Relay 711) if you have questions about: 

  • Urgent care 
  • Your health, medications, or a chronic condition 
  • Whether you should go to the emergency room (ER) or see your PCP 
  • What to do for a sick child 
  • How to handle a condition in the middle of the night 
  • Accessing our online health information library 

   Urgent Care

Urgent Care is for when you have an injury or illness that must be treated within 24 to 72 hours and is not life threatening. Go to an urgent care clinic if you need care and your PCP is unable to see you. You do not need an appointment. Consider Urgent Care for small wounds, simple sprains and broken bones, ear infections, and urinary tract infections.   

Be sure to choose an in-network urgent care center to save on costs. Use Find a Provider to find urgent care near you.

   Emergency Room (ER)

If you have a life-threatening injury or illness, do not wait! Call 911 or go directly to the ER. A medical emergency is a sudden illness or condition that could result in serious harm to you and needs care right away. For example, bleeding that will not stop, severe pain, chemical poisoning, drug overdose or thoughts of harming yourself or others. Choose other care options if your injury is minor to maximize your benefits and lower your costs. Consider all your options before going to the ER.   

Watch the video to learn more about your choices for care when you are sick or hurt. 

   988 Suicide and Crisis Lifeline

The 988 Lifeline provides confidential help when you need it quickly. To connect:  

988 can help you or a family member with mental health, drug use, or suicidal concerns. Contact 988 if you have thoughts of hurting yourself or others.  

Health Insurance 101

Know these health insurance terms to make the most out of your Ambetter Health Enhanced Asthma/COPD Care Silver plan. 

Network 

A health insurance network is a group of doctors, hospitals, clinics, and other healthcare providers. These providers are part of your plan.

  • In-network (INN) providers partner with your health plan. When you use their services, your plan typically covers a larger portion of costs, and you pay less.
  • Out-of-network (OON) providers are not part of your network. If you see a doctor who is out of your network, you may have to pay more. Some plans may cover a smaller portion of the cost, but many do not cover out-of-network services at all. That is why it is best to stay in-network. . 

Primary Care Provider (PCP) 

Your Primary Care Provider (PCP) is your main point of contact for care. This can be a doctor, a physician assistant, or a nurse practitioner.

See your PCP for wellness and sick visits, checkups, vaccinations, or for mental wellness. Your PCP can assess your symptoms, give you initial treatment, help you with your medication and refer you to a specialist when it is necessary. 

As an Enhanced Asthma/COPD Care Silver plan member, you may be assigned a PCP. You can view or change your PCP in your Online Member Account.

Why is it good to have a PCP? 

  • Your PCP gets to know you and your medical history. This helps you get care that's right for you. 
  • Your PCP handles your preventive care. Regular checkups, screenings and vaccinations can help prevent health issues. 
  • If you have diabetes, asthma or another chronic condition, your PCP keeps track of it and helps you get consistent care. 

Premium

A Premium is a fixed fee you will pay each month for your health insurance plan. 

Copay 

A copay (or copayment) is a set fee you pay for a doctor visit or prescription. You typically pay it during your visit. 

Copays are common for these medical services: 

  • Doctor or specialist visit 
  • Urgent care visit 
  • Emergency room (ER) visit
  • Prescriptions 

Not all health plans have copays. Usually, plans with a high deductible do not have copays for doctor visits or prescription drugs. You can find your copay information on your Member ID Card.

Deductible 

A deductible is the money you need to pay for the covered services you are using before your plan starts to pay. Before you reach your deductible, you are responsible for the full costs of your care. Deductibles reset every year. 

Most health plans have a deductible, but the amounts can vary. A plan with a higher monthly premium often has a lower deductible. Lower monthly payments generally mean a higher deductible. 

Your deductible may also depend on where you go for care. Typically, you pay less when you get care from a doctor who is in your network. 

Coinsurance 

Coinsurance is a type of cost-sharing. Usually, coinsurance begins once you pay your deductible. Coinsurance is as a percentage that you need to pay for covered services. It is a smaller portion of the full cost, and your insurance covers the rest. 

Maximum Out of Pocket (MOOP)

This is the maximum amount of money you can pay for covered services in a year. Once you reach this limit, your plan typically covers the full cost of covered services for the rest of the year. 

  

Frequently Asked Questions

A PCP is your Primary Care Provider. It is where you go for checkups, vaccinations or if you have fever or cold. Your PCP also cares about your ongoing issues like allergies, diabetes or asthma.

Go to the Find a Provider and select the Enhanced Asthma/COPD Care Silver network. Use the search to find an in-network provider of your choice. 

Check your plan's formulary to find out the exact brand names and quantities of the medications and supplies covered by your plan.

You can access urgent care virtually or in person without a referral. 

  • For a virtual visit: Go to your online member account and select “Virtual 24/7 Care” on the right side of the homepage to schedule your visit. 
  • For an in-person visit: Find a nearby urgent care clinic using the Find a Provider tool. Choose the Enhanced Asthma/COPD Care Silver network and search for “Urgent Care.”

No. As a Enhanced Asthma/COPD Care Silver plan member, you can choose to see any in-network specialist. Your plan will cover this visit. To find a doctor in your network, use the Find a Provider tool. Be sure to select your state, plan year and theEnhanced Asthma/COPD Care Silver network before searching. 

Most out-of-network services are not covered by your plan. You will have to pay in full for any out-of-network visits. The only exception is if you have a PPO plan. To choose a doctor in your network, use the Find a Provider tool. Be sure to select your state, plan year and the Enhanced Asthma/COPD Care Silver network before searching. 

 

*The benefits, rates and costs listed in these advertisements are illustrative and are based on a specific household size, specific age, smoker status, and in a specific coverage area in North Carolina. A person should not send money to the issuer of the health benefit plan in response to the advertisement. A person cannot obtain coverage under the health benefit plan until the person completes an application for coverage. This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. This policy has provisions relating to renewability, cancellability, and termination, and may include provisions for modification of benefits, losses covered or premiums because of age or for other reasons. For costs and complete details of the coverage, call or write your insurance producer or the company, whichever is applicable.

Additional information is available in the Evidence of Coverage.

**Cost sharing may apply when using Virtual 24/7 Care. Ambetter Health does not provide medical care. Medical care is provided by individual providers which are independent contractors and not agents of Ambetter Health.

***Healthcare-related costs will vary by member and the plan in which you are enrolled. Funds expire immediately upon termination of insurance coverage. My Health Pays® rewards cannot be used for pharmacy copays. Restrictions apply. Members must qualify for and complete all activities to receive $500 or more. Visit My.AmbetterHealth.com for more details. Your health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all members. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact us at 1-833-863-1310 (Relay 711) and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status.

Ambetter of North Carolina Inc. is underwritten by Ambetter of North Carolina Inc. which is a Qualified Health Plan issuer in the North Carolina Health Insurance Marketplace. This is a solicitation for insurance. ©2025 Ambetter of North Carolina Inc., AmbetterHealth.com/en/nc. If you, or someone you’re helping, have questions about Ambetter of North Carolina Inc., and are not proficient in English, you have the right to get help and information in your language at no cost and in a timely manner. If you, or someone you’re helping, have an auditory and/or visual condition that impedes communication, you have the right to receive auxiliary aids and services at no cost and in a timely manner. To receive translation or auxiliary services, please contact Member Services at 1-833-863-1310 (Relay 711). For more information on your right to receive an Ambetter of North Carolina Inc. plan free of discrimination, or your right to receive language, auditory and/or visual assistance services, please visit AmbetterHealth.com and scroll to the bottom of the page.