Purpose

Carolina ACCESS is a Managed Care program that links all eligible Medicaid recipients with a Primary Care Physician. The Primary Care Physician delivers and coordinates all of the Medicaid recipient's health care needs. The goals of Carolina ACCESS are to:

1. Improve access to primary care.
2. Establish comprehensive patient/physician relationships.
3. Reduce inappropriate use of emergency room services.
4. Improve and increase primary care physician participation in Medicaid.
5. Promote the preventive aspects of health care.
6. Optimize the state and counties' investment in health care for Medicaid recipients.

Eligibility

Mandatory participation is required in AAF (Work First family assistance), MAD (Medicaid for the aged and disabled), MAB (Medicaid for the blind), MAF (Medicaid for families), MIC (Medicaid for infants and children), and SAD (Special Assistance for the disabled) categories. 

Medicaid recipients in HSF (Medicaid for non-Title IV-E foster care children), IAS (Medicaid Title IV-E adoption subsidy foster care children), MPW (Medicaid for Pregnant Women), and MAA (Aid to the aged) are optional categories for participation in Carolina ACCESS. Medicare recipients who have Medicaid can also choose to participate. 

If a Medicaid recipient, regardless of category, has a terminal illness, has an accident that requires a lot of rehabilitation, or is premature, the recipient is exempted from participation in Managed Care.

Financial Guidelines

Once the recipient meets eligibility requirements for Medicaid, they are automatically eligible for Managed Care/Carolina ACCESS.