Behavioral Health I/DD Tailored Plan

North Carolina will launch the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan. This is an integrated health plan for individuals with behavioral health needs and intellectual/developmental disabilities (I/DDs).

Tailored Plan Implementation Delayed 
Beneficiaries who will be covered by the Tailored Plans will continue to receive care as they do today.
To ensure beneficiaries can seamlessly receive care on day one, NCDHHS is delaying the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/ Developmental Disabilities Tailored Plans (Tailored Plans) scheduled for Oct. 1, 2023, but will now go forward at a date still to be determined. Beneficiaries who will be covered by the Tailored Plans will continue to receive care as they do today. 

Tailored Plans will also serve other special populations including Innovations and Traumatic Brain Injury (TBI) waiver enrollees and waitlist members and will be responsible for managing the state’s non-Medicaid behavioral health, developmental disabilities and TBI services for uninsured and underinsured North Carolinians.

The following organizations will serve as regional Behavioral Health I/DD Tailored Plans:

• Alliance Health alliancehealthplan.org
  • Member phone numbers: 800-510-9132, TTY: 711 or 800-735-2962
• Eastpointe eastpointe.net
  • Member phone numbers: 800-913-6109, TTY: 888-819-5112
• Partners Health Management partnersbhm.org
  • Member phone numbers: 888-235-4673, TTY: English: 800-735-2962, TTY: Spanish: 888-825-6570
• Sandhills Center sandhillscenter.org
  • Member phone numbers: 800-256-2452, TTY: 711 or 866-518-6778
• Trillium Health Resources trilliumhealthresources.org
  • Member phone numbers: 877-685-2415, TTY: 711
• Vaya Health vayahealth.com
  • Member phone numbers: 800-962-9003, TTY: 711

Contact information for each of the Tailored Plan organizations can be found on the Health Plan webpage.

Tailored Care Management

As North Carolina transitions its Medicaid and NC Health Choice program to managed care, the Department is focused on building effective models for managing beneficiaries comprehensive needs through care management. The Department is investing in the Tailored Care Management model, a community-based, provider-driven model aimed at whole person care and driving toward better health outcomes.  

Through Tailored Care Management, Tailored Plan beneficiaries will have a single designated care manager supported by a multidisciplinary care team to provide integrated care management that addresses all of their needs including: physical health, behavioral health, I/DD, TBI, pharmacy, long-term services and supports (LTSS) and addresses their unmet health-related resource needs. More information on Tailored Care Management is available on the Tailored Care Management webpage.

Resources

Behavioral Health and Intellectual/Developmental Disabilities Services