Make sure your local Department of Social Services (DSS) has your current mailing address, phone number and email address so you receive all important information. You can find your local county DSS at dhhs.gov/localdss. * Report all changes, including your address and any changes such as income or a change in household (the number of family […]
FAQ Category: Uncategorized FAQ
To choose a PCP or Tailored Care Management (TCM) provider with your Tailored Plan, contact your Tailored Plan directly. If you are getting TCM services now, you will keep your TCM provider. If you do not choose a PCP by May 15, 2024, one will be assigned to you.
NC Medicaid will transition beneficiaries who may need certain services for a severe mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI) to Tailored Plans) July 1, 2024. Until then, potential Tailored Plan beneficiaries will receive health care services the same way they do today, through NC Medicaid Direct or […]
NC Medicaid beneficiaries will be assessed for Tailored Plan eligibility. Eligible beneficiaries will get a letter from the NC Medicaid Enrollment Broker in mid-April. The letter will tell you if you have been auto-enrolled in a tailored Plan or if you have the choice to opt-in. To learn more about the move to Tailored Plans, […]
LME/MCOs currently only manage behavioral health services. Once Tailored Plans launch, they will manage all Medicaid services for their members, including physical health services. Your primary care provider (PCP) must be in the Tailored Plan’s network. If they are not, you will likely have to change to a different PCP.
A Tailored Plan company coordinates services for Tailored Plan members. There are four Tailored Plans in North Carolina: Alliance Health, Partners Health Management, Trillium Health Resources, and Vaya Health.
Standard plans provide integrated physical health, behavioral health, pharmacy and long-term services and support to most Medicaid beneficiaries, as well as other programs and services that address unmet health-related resource needs
Tailored Plans are a new kind of NC Medicaid Managed Care health plan. They start July 1, 2024. Tailored Plans cover your physical care, prescription drugs, and services for serious mental illness, severe substance use disorders, intellectual/developmental disabilities (I/DD) and traumatic brain injury (TBI) in one health plan. Tailored Plans will also serve people on […]
Some people can change their health plan at any time. You can change your health plan at any time for these reasons: * You need services to address a mental health disorder, substance use disorder, intellectual/developmental (I/DD) or traumatic brain injury (TBI) * You are a federally recognized tribal member or qualify for services through […]
You can call us at 877-201-3750 from 8 a.m. to 5 p.m., Monday through Friday except for State holidays. We do our best to answer every call, but if we are unable to answer, please leave a message with your name and phone number. We’ll call you back by the next business day. You can […]
