Each plan below has recorded coverage in North Carolina. The lines of business shown are the ones that plan operates in this state — a carrier can run commercial business in one state and Medicaid managed care in the next, and each line is a separate contract.
Coverage data as of July 28, 2026. Payer footprints change with contract cycles; we verify against current payer requirements at the start of any engagement.
National carriers
National carriers credential centrally, so one application generally covers every state you practice in. Network participation and fee schedules are still contracted separately by state and by line of business.
| Payer | Parent company | Lines of business in North Carolina | Credentialing guide |
|---|---|---|---|
| Aetna | CVS Health | CommercialMedicare Advantage | Full guide |
| Alignment Health Plan | Alignment Healthcare | Medicare Advantage | — |
| Ambetter Health | Centene Corporation | Marketplace | Full guide |
| AmeriHealth Caritas | Independence Health Group / Blue Cross Blue Shield of Michigan (joint venture) | Medicare AdvantageMedicaidMarketplace | — |
| Centene Corporation | Independent | Medicare AdvantageMedicaidMarketplace | Full guide |
| Cigna Healthcare | The Cigna Group | CommercialMarketplace | Full guide |
| Devoted Health | Independent | Medicare Advantage | — |
| GEHA | Independent | Commercial | — |
| Humana | Independent | Medicare Advantage | Full guide |
| Oscar Health | Independent | Marketplace | — |
| UnitedHealthcare | UnitedHealth Group | CommercialMedicare AdvantageMedicaidMarketplace | Full guide |
| Wellcare | Centene Corporation | Medicare AdvantageMedicaid | Full guide |
Blue Cross Blue Shield plans
Blue Cross Blue Shield is a federation of independent licensees. Each plan credentials on its own — being in-network with one Blue plan does not make you in-network with another.
| Payer | Parent company | Lines of business in North Carolina | Credentialing guide |
|---|---|---|---|
| Blue Cross and Blue Shield of North Carolina | Independent | CommercialMedicare AdvantageMedicaidMarketplace | Full guide |
| Blue Cross Blue Shield Association | Independent | Commercial | Full guide |
| Health Care Service Corporation | Independent | Medicare Advantage | Full guide |
Medicaid managed care
Medicaid managed-care organizations contract under a state Medicaid agency. Most require an active state Medicaid provider ID before they will begin credentialing, so the state enrollment has to finish first.
| Payer | Parent company | Lines of business in North Carolina | Credentialing guide |
|---|---|---|---|
| Alliance Behavioral Healthcare | Independent | Medicaid | — |
| Carolina Complete Health | Centene Corporation | Medicaid | Full guide |
| Partners Behavioral Health Management | Independent | Medicaid | — |
| Trillium Health Resources | Independent | Medicaid | — |
| Vaya Health | Independent | Medicaid | — |
Regional & local plans
Regional plans operate in a limited footprint and more often credential in-house rather than through a delegated CVO. Turnaround varies more than it does with national carriers.
| Payer | Parent company | Lines of business in North Carolina | Credentialing guide |
|---|---|---|---|
| Experience Health | Blue Cross and Blue Shield of North Carolina | Medicare Advantage | — |
| HealthTeam Advantage | Risant Health | Medicare Advantage | — |
| Liberty Medicare Advantage | Liberty Healthcare Insurance | Medicare Advantage | — |
| Longevity Health Plan | Longevity Health Founders | Medicare Advantage | — |
| NHC Advantage | Missouri Healthcare Advisors | Medicare Advantage | — |
| Provider Partners Health Plans | Rifkin Managed Care Holding | Medicare Advantage | — |
| PruittHealth Premier | UNICO Services | Medicare Advantage | — |
| Troy Medicare | Troy Holdings | Medicare Advantage | — |
Networks & IPAs
Networks, IPAs, and rental networks aggregate provider panels. Joining one can reach several payers at once, but the contracting party is the network — not the payer whose members you end up seeing.
| Payer | Parent company | Lines of business in North Carolina | Credentialing guide |
|---|---|---|---|
| ChoiceCare Network | Humana | Commercial | — |
| Evernorth Behavioral Health | Cigna Healthcare | Commercial | — |
| First Health Network | Aetna | Commercial | — |
| Galaxy Health Network | Independent | Commercial | — |
| HealthSmart | Independent | Commercial | — |
| MultiPlan (Claritev) | Claritev Corporation | Commercial | — |
| PHCS Network | MultiPlan (Claritev) | Commercial | — |
| Prime Health Services | Independent | Commercial | — |
| Three Rivers Provider Network (TRPN) | Independent | Commercial | — |
| UMR | UnitedHealthcare | Commercial | — |
| Zelis Network | Zelis Healthcare | Commercial | — |
Government programs
Government programs enroll providers through their own systems rather than commercial credentialing. Enrollment is usually a prerequisite for participating in the managed-care plans built on top of them.
| Payer | Parent company | Lines of business in North Carolina | Credentialing guide |
|---|---|---|---|
| Humana Military | Humana | Government program | Full guide |
| Medicare (Original Medicare / Part A & B) | Centers for Medicare & Medicaid Services | Government program | Full guide |
| VA Community Care Network | U.S. Department of Veterans Affairs | Government program | — |
Credentialing in North Carolina
Read our North Carolina guide for how Medicare, state Medicaid, the local Blue plan, and the commercial carriers fit together: provider credentialing in North Carolina.
Get in-network in North Carolina
We handle the applications, the portals, and the follow-up until you have an effective date in hand.
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