Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.
2026 Quick Reference Guide
About Your Plan
This is a guide to your Ambetter of North Carolina Inc. plan. It is aimed to help you take charge of your health and get the most out of your benefits.
Your Primary Care Provider
Your Primary Care Provider (PCP) is your main physician or provider that helps you with your basic medical needs. To view or change your PCP, go to findaprovider.ambetterhealth.com.
Make sure your PCP is in-network. This means the doctor, pharmacy, or facility is included in the Ambetter Health network. Always use in-network services and providers to prevent additional costs.
Ways to Pay
- Log in to your Online Member Account to make a payment or set up automatic bill pay.
- Make a payment in the Ambetter Health mobile app.
- Make a one-time payment.
- Visit Ways to Pay for more options.
After your first month’s premium is paid in full, you will receive your Welcome Packet and Member ID Card(s).
Create Your Online Member Account
Set up your secure account at My.AmbetterHealth.com.
- Access all your plan details
- Save your digital member ID Card
- Search for care
- View your claims
Download the Ambetter Health App
Scan the QR code or log in online at AmbetterHealth.com/Connect
Where to Go for Care
From primary care to urgent care and virtual medicine, you have options with Ambetter Health.
Primary Care Provider (PCP)
Your PCP is your main physician and your first choice for care.
Virtual 24/7 Care*
Talk to a doctor online or over the phone. Get the care you need anytime, anywhere.
Urgent Care
Go to an Urgent Care Clinic if you need immediate care and your PCP is unable to see you. You do not need an appointment.
Emergency Room (ER)
If you have a medical emergency, do not wait! Call 911 or go straight to the ER.
24/7 Nurse Advice Line
Talk to a registered nurse any time of the day or night with this free service. The 24/7 Nurse Advice Line provides quick, reliable advice for medical situations that aren’t life-threatening. 1-833-863-1310 (Relay 711)
988 Suicide and Crisis Lifeline
Call or text 988 for help with mental health, drug use, or suicidal concerns when you need it quickly and confidentially.
Learn more about the care options available to you at AmbetterHealth.com/CareOptions.
Stay Healthy and Stay Well
Get the most from your Ambetter Health insurance with our health and wellness benefits. As an Ambetter Health Member, you have access to:
Mental & Behavioral Health Services
Your plan includes mental and behavioral health services. You can also access services through Virtual 24/7 Care.
Preventive Care
Be sure to schedule your annual wellness exam with your in-network PCP.
Ambetter Member Perks
Save on health products and services with our discount program.
My Health Pays® Rewards Program**
Use it to help pay for healthcare related costs, monthly bills, and more. Access My Health Pays through your Online Member Account.
A Trusted Provider Network
Access a range of providers, medical facilities, and hospitals.
Prescription Drug Coverage
Get brand and generic drugs delivered to your door.
Benefits for Members with Diabetes
If you’re enrolled in the Clear Silver with $0 Insulin Options plan, you have access to $0 copays*** for preferred insulins and select mental health medications. These benefits are designed to make managing diabetes easier and more affordable.
Coverage that Supports Lung Health
New for plan year 2026, the Enhanced Asthma/COPD Care Silver with $0 Drug Options plan offers extra support to help manage asthma or COPD while lowering out-of-pocket costs. This plan includes $0*** copays for preferred inhalers, select medications, pulmonologist visits, and care management services.
Learn more about your programs, perks, and more at AmbetterHealth.com/Programs-NC. Read about your coverage details in your Summary of Benefits and Coverage or your Evidence of Coverage at AmbetterHealth.com/Plans-NC.
Member Services
Not a member yet? Visit Enroll.AmbetterHealth.com.
Free Interpreter Services
If you need information in languages other than English, call Member Services.
Interpreter services allow you and your physician to talk about your medical or behavioral health concerns in a way that is most comfortable for you. Members who are blind or visually impaired and need help with interpretation can call Member Services for an oral interpretation.
Enrollment Information
If you enroll through the Health Insurance Marketplace each year, you must update or choose a new health plan. You can do this during open enrollment or during a special enrollment period if you have a life changing event. When you are enrolled in an off-exchange plan, please contact Member Services to update your enrollment information, such as your date of birth, address or income or life changes. You can do this by calling 1-833-863-1310 (Relay 711). We’re available Monday through Friday, 8 a.m. to 8 p.m. local time.
Need help or have questions?
Call Member Services or contact your broker directly.
Member Services: 1-833-863-1310 (Relay 711). We are available Monday through Friday, 8 a.m. to 8 p.m. local time.
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.
*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.
***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.