Contact Us

Subject Area Contact Information
Health Plan
Enrollment & Eligibility Questions
For questions regarding enrollment or eligibility, or assistance with the e-Enroll enrollment system, please call the Eligibility and Enrollment Center at:

855-859-0966

Traditional 70/30, Enhanced 80/20 and CDHP Benefit Questions
For questions regarding benefits, to make address changes, or any claim inquiries, call or write to:

Customer Service
PO Box 30085
Durham, NC 27702
Phone: 888-234-2416
M-F 8AM to 6PM

Humana Group Medicare Advantage (PPO) Base and Enhanced Plan Benefit Questions
For questions regarding benefits, call or visit the website:

Humana
Customer Service: 800-944-9442

UnitedHealthcare Group Medicare Advantage (PPO) Base and Enhanced Plan Benefit Questions
For questions regarding benefits, call or visit the website:

UnitedHealthcare
Customer Service: 866-747-1014

Member Services
Members enrolled in the Traditional 70/30, Enhanced 80/20 Plans and CDHP can log into member services to request an ID card, view your claims on line, and even find a provider near you.

Blue Cross & Blue Shield of North Carolina

BCBSNC Member Services

Medical Claim Filing and Inquiries
To file a medical claim or inquire about the status of a medical claim you have already filed and are enrolled in the Traditional 70/30, Enhanced 80/20 Plans or CDHP:
State Health Plan
c/o BCBSNC
PO Box 30087
Durham, NC 27702
Phone: 888-234-2416
Where to Mail Your Premiums
SHP premium payments for both Group and Individuals (Retirees/COBRA/Surviving Spouse)

North Carolina State Health Plan – Direct Bill
P.O. Box 505211
St. Louis, MO 63150

877-679-6272

Hospital Pre-admission Certification/Prior Approval

To request prior authorization (certification) for certain out-of-network or out-of-state services for members enrolled in the Traditional 70/30, Enhanced 80/20 Plans and CDHP:
Blue Cross & Blue Shield of North Carolina
800-672-7897
Mental Health and Chemical Dependency
For precertification for mental health services and chemical dependency for members enrolled in the Traditional 70/30, Enhanced 80/20 Plans and CDHP:

ValueOptions
PO Box 12438
RTP, NC 27709
ValueOptions
Phone: 800-367-6143

Appeals and Grievance
To appeal a claim decision or to file a grievance with the State Health Plan:
State Health Plan
c/o BCBSNC Appeals Department
PO Box 30055
Durham, NC 27702-3055
Phone: 888-234-2416
Fax: 919-765-2322
Pharmacy (Traditional Pharmacy Benefits)
Prescription Drugs
To file a claim for prescription drugs, locate pharmacies within the State Health Plan network, or learn about the Plan's preferred prescription drugs:
Express Scripts
PO Box 14711
Lexington, KY 40512
Medco
Phone: 800-336-5933
Prescription Drugs Prior Authorization
To initiate a prior authorization request of your prescription drugs:
Express Scripts Prior Authorization
Phone: 800-753-2851
Fax: 800-837-0959
Questions, Comments or Concerns?
State Health Plan Member Inquiries
Your comments and concerns are important to us. To share comments or concerns on specific medical or pharmacy issues, use this e-mail: (Please note: it is not recommended that you include your Social Security, member ID or other identifying personal numbers.)
General Feedback
For any other general comments and suggestions, please e-mail us at this address:
Customer Experience
State Health Plan Member Inquiries
Do you have questions about what is happening at the State Health Plan? E-mail us at:
Media Inquiries
For media questions, call:
Department of State Treasurer
Media Line: 919-807-3132
Report Fraud and Abuse Section
To find out how to report suspected fraud and abuse to the State Health Plan:
Fraud Section
Phone: 800-324-4963
Patient Protection Act
For information on requesting an External Review of claims decisions (after all internal grievance procedures have been exhausted):
North Carolina Department of Insurance
Phone: 800-546-5664
Health Management
NC HealthSmart
Learn how to better manage your health and much more:
Phone: 800-817-7044
Kidney Disease Program
For assistance with the Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) Case Management Program:
866-577-3625
Retirees
Retirement System
NC Department of State Treasurer
NC Retirement Systems
Phone: 877-733-4191 or 919-733-4191
Seniors Health Insurance Information Program (SHIIP)
For Medicare Beneficiaries: SHIIP, a division of the N.C. Department of Insurance, offers free, objective information about Medicare, Medicare Advantage plans, Medicare claims, Medicare supplement insurance, Medicare Prescription Drug Plans, fraud and abuse prevention as well as long-term care insurance:
Seniors Health Insurance Information Program
Phone: 800-443-9354 or 919-807-6900
Social Security Administration
For specific questions about Medicare premiums and claims, call or write to:
Centers for Medicare & Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850

Phone: 800-772-1213
Phone: 800-MEDICARE
Employment
Careers at the State Health Plan
Board of Trustees
State Health Plan Board of Trustees
State Health Plan Office
State Health Plan Office
4901 Glenwood Avenue, Suite 300
Raleigh, NC 27612
919-881-2300
Find a Doctor
Personal Health Portal - NC Health<em>Smart</em>