Special to IFN

RALEIGH — The N.C. Department of Health and Human Services has launched its Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans, a new kind of NC Medicaid Managed Care health plan.

“With Tailored Plans, we can invest in the health and well-being of more than 210,000 people by addressing their physical and behavioral health needs in one health plan,” said NCDHHS Secretary Kody H. Kinsley. “This is another critical milestone in our work to build a stronger, more outcomes-oriented and accessible behavioral health system for North Carolina.”

Effective July 1, people eligible for Tailored Plans include those covered by NC Medicaid who have a serious mental illness, a serious emotional disturbance, a severe substance use disorder, an intellectual or developmental disability or a traumatic brain injury. Tailored Plans cover services for physical care, prescription drugs, mental health, long-term services and supports and address unmet health-related resource needs.

“We have worked closely with all health plan partners to ensure they are ready to serve and support members as North Carolinians move to these new plans,” said NC Medicaid Deputy Secretary Jay Ludlam. “On day one, members should be able to get access to the services and supports they need — whether it is physical health, behavioral health or access to the drugs that they need.”

In April, the NC Medicaid Enrollment Broker mailed a letter to North Carolinians who are moving to Tailored Plans about next steps and how to choose a primary care provider. Individuals who did not pick a PCP by the May 15 deadline were assigned one, which they can change (without cause or for any reason) through January 31, 2025. Individuals moved to Tailored Plans should have also received a welcome packet and new member health plan ID card from Alliance Health, Partners Health, Trillium Health or Vaya Total Care. If they did not receive a welcome packet but think they should be in a Tailored Plan, they can call the NC Medicaid Enrollment Broker at 833-870-5500 (TTY: 711 or RelayNC.com) for support.

To help people better navigate the transition, NCDHHS has published an accessible communications toolkit. The communication toolkit includes flyers, an explainer presentation, social media graphics and more. These resources are available in English and Spanish.

“It’s so important that all North Carolinians have the tools and resources they need to live healthy and fulfilling lives,” said Kelly Crosbie, director of the NCDHHS Division of Mental Health, Developmental Disabilities, and Substance Use Services. “The Tailored Plan toolkit makes it easier than ever for individuals with mental health or substance use issues, an intellectual or developmental disability or a traumatic brain injury to navigate the transition to Tailored Plans and understand the services that are available to them.”

LEARN MORE

For more information on Tailored Plans, visit Medicaid.nc.gov/tailored-plans.

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