Ollie Super, an 8-year-old from Eden, North Carolina, faced a critical delay in receiving CAR T-cell therapy for recurrent neuroblastoma when the state’s new Medicaid-managed care plan for children in foster care refused to cover the treatment.
Ollie was diagnosed as a toddler while in foster care and was adopted in 2020. Her cancer returned late last year, and her parents sought to enroll her in a clinical trial involving genetically reprogrammed T-cell therapy at UNC Health in Chapel Hill. However, in early March, UNC Health’s financial office informed the family that the state’s specialized insurance plan, Healthy Blue Care Together, would not pay for the treatment.
This insurance plan, launched on December 1, 2025, enrolled Ollie along with approximately 32,000 other children served by the foster care system in North Carolina. Healthy Blue Care Together is a specialized managed care program under Medicaid, designed to improve coverage for foster children and those adopted from foster care. Yet many healthcare providers, including UNC Health, initially did not participate in the plan, leaving families uncertain about access to necessary care.
After more than two months of uncertainty, UNC Health reached an agreement with Blue Cross Blue Shield of North Carolina, which administers the plan, in mid-March. Despite this progress, some providers remain outside the network, and caregivers report challenges such as limited access to medical records, prescription delays, canceled appointments, and administrative difficulties during the transition.
Melanie Bush, interim deputy secretary for North Carolina’s Medicaid program, stated that the state is urging Healthy Blue to expand its provider network, which the insurer describes as adequate. Blue Cross Blue Shield declined to provide detailed statistics on provider participation.
Ollie’s mother, Britany Super, described the CAR T-cell therapy as her daughter’s “last option” after multiple rounds of chemotherapy, radiation, and stem cell transplants since diagnosis at age 2. With cancer spreading, Ollie’s treatment will now involve weekly hospital visits for chemotherapy before advanced therapy can proceed.
The financial burden of treatment, which costs millions, is significant for the family. Having reliable insurance coverage through the managed care plan means Ollie’s bills are covered, allowing her family to focus on her care and recovery.
Why it matters
North Carolina’s new specialized insurance plan for children in foster care aims to meet their complex health needs, but early implementation challenges have led to care disruptions and provider network gaps. This case highlights broader difficulties states face in ensuring timely access to specialty treatment under foster care Medicaid plans amid ongoing Medicaid funding uncertainties.
Background
Specialized managed care plans for children in foster care are increasingly adopted nationwide to address often complex medical needs. Alongside North Carolina, 13 other states have similar programs, but many have experienced rollout problems, including provider shortages and access challenges.
Previous studies in states like Texas, Florida, Illinois, California, and Georgia have documented varying degrees of network inadequacies, delayed care, and legislative responses aimed at restoring coverage options. Experts caution that without robust data and careful monitoring, these plans risk disrupting care continuity for vulnerable children.
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