The Children and Families Specialty Plan (CFSP) is a new NC Medicaid Managed Care health plan.  

It is a single, statewide health plan that will be managed by Blue Cross and Blue Shield of North Carolina under the name Healthy Blue Care Together.  

Potential Children and Families Specialty Plan beneficiaries include NC Medicaid-enrolled children, youth and young adults currently and formerly served by NC Child Welfare. The Children and Families Specialty Plan will launch Dec. 1, 2025.

Until then, potential beneficiaries will continue to get health care services the same way they do today – through NC Medicaid Direct.

The Children and Families Specialty Plan is designed to provide beneficiaries with seamless, integrated, coordinated health care. Having a statewide health plan will ensure beneficiaries have access to the health care they need and can continue to receive care from their providers if their foster care placement causes them to move to another location in the state.  

The health plan is part of North Carolina’s commitment to improve the long-term health and well-being of children who receive Child Welfare services.  

• One single statewide plan: The health plan will operate statewide as the single entity accountable for the health care of its beneficiaries, simplifying processes and providing caregivers, providers, case workers and families with information to provide the right care at the right time.
• Informed by local needs: The health plan will collaborate with local Departments of Social Services, local stakeholders and families to understand and respond to needs in each community. Care managers will be located within the community to support this work.
• Prevention focused: The health plan will take a family-focused approach to care delivery to strengthen and preserve families, reduce entry and reentry into foster care and support reunification and other permanency plan options.
• Comprehensive care: The health plan will increase timely access to a broad range of physical health, behavioral health, pharmacy, long term services and supports and intellectual/development disabilities services and unmet health-related resource needs for all beneficiaries.
• Coordinated care: Care management will be provided to all beneficiaries to support integrated, whole-person care and facilitate coordination among service providers. It will also facilitate seamless transitions for beneficiaries who experience changes in treatment settings, child welfare placements, transitions to adulthood and/or loss of Medicaid eligibility.

The Children and Families Specialty Plan will meet the unique needs of NC Medicaid-enrolled children, youth and young adults currently and formerly served by NC Child Welfare. The plan will:

• Operate statewide and increase access to a broad range of physical health, behavioral health, pharmacy, long-term services and supports, intellectual/developmental disabilities services and unmet health-related resource needs for all beneficiaries.  
• Having a statewide health plan will ensure beneficiaries have access to the health care they need and can continue to receive care from their providers if their foster care placement causes them to move to another location in the state.  
• Take a family-focused approach to care delivery to strengthen and preserve families, prevent entry and reentry into foster care, support reunification and other permanency plan options.
• Closely coordinate with the Division of Social Services, local Departments of Social Services, Eastern Band of Cherokee Indian Family Safety Program and more broadly, with the System of Care, a comprehensive network of community-based services and supports.
• Provide care management (coordinate health care services) to all beneficiaries to support integrated, whole-person care and foster coordination across providers.
• Support beneficiaries in shared decision-making during transitions, including between health care settings and when transitioning out of foster care or Medicaid.
• Build a statewide provider network and train providers and plan staff in the unique needs and experiences of children, youth and young adults currently and formerly served by NC Child Welfare.  
• Make sure all beneficiaries receive high-quality health care that promotes overall health and well-being. 

NC Medicaid beneficiaries who are in foster care, receiving adoption assistance and enrolled in the former foster care eligibility will be eligible for the Children and Families Specialty Plan.

Most beneficiaries eligible for the Children and Families Specialty Plan will be automatically enrolled in the health plan. This includes:  

• Children and youth currently in foster care
• Children and youth currently receiving adoption assistance
• Young adults under age 26 formerly in foster care
• Minor children of these populations  

Beneficiaries of a federally recognized tribe or eligible for Indian Health Services eligible for the Children and Families Specialty Plan will not be auto-enrolled but can voluntarily enroll in the Children and Families Specialty Plan.