Getting Started with Tailored Care Management

If you are eligible for Tailored Care Management, a Tailored Care Manager will automatically be assigned to you. Here’s how to get started:

1. Consent (or agree) to Tailored Care Management

If you want Tailored Care Management, you need to consent (or agree) by telling your Tailored Care Manager. You should have received a letter with your Tailored Care Manager’s information.

Not sure who your Tailored Care Manager is? These Medicaid health plans offer Tailored Care Management. If you do not know who your Tailored Care Manager is, call the one listed on your health plan ID card or in your health plan welcome letter. Ask for your Tailored Care Manager’s contact information.

Your Tailored Care Manager may call or send you a letter to ask for your consent. This call or letter may come from a certified Tailored Care Management provider in your community.

To check if the person calling you is really your Tailored Care Manager: Call the number listed on your health plan ID card and ask, “Who is my Tailored Care Manager?”  

Your Tailored Care Manager will never ask you for your credit card, banking information or social security number.

If they never hear from you, your Tailored Care Manager will assume you do not want Tailored Care Management. Learn more about opting out of Tailored Care Management.

2. Meet your Tailored Care Manager in-person

After you opt in (or agree) to Tailored Care Management, your Tailored Care Manager will schedule an in-person meeting to better understand your needs.

They can meet you at your home or at a convenient place. They might be able to have this meeting over the phone or video chat, but in-person is encouraged.

To get a better understanding of all of your needs, they will ask you questions about these areas:

  • Physical health
  • Mental health
  • Food and nutrition
  • Transportation
  • Housing
  • Personal safety
  • School or work

Your answers will help your Tailored Care Manager know how they can best help you. You do not have to answer any questions you do not want to.  

Based on what you need, your Tailored Care Manager will create a personalized care plan and start organizing any relevant services for you. Learn more about the different ways Tailored Care Managers can help you.

Need help?

These NC Medicaid health plans offer Tailored Care Management. Call the one listed on your health plan ID card or in your health plan welcome letter:

Don’t see your plan? Tailored Care Management is only available with Tailored Plans or NC Medicaid Direct; it is not available with Standard Plans or Eastern Band of Cherokee Indians (EBCI) Tribal Option. See contact information for all Medicaid health plans.

Not sure who to call? Call the number on your health plan ID card. Or call the NC Medicaid Enrollment Broker at 1-833-870-5500. Hours of operation: 7 a.m. to 5 p.m., Monday through Saturday. They can tell you which plan you have.

If you have a complaint or concern, or you need help understanding your rights and responsibilities: Call the NC Medicaid Ombudsman at 1-877-201-3750. Hours of operation: 7 a.m. to 5 p.m., Monday through Saturday. They are an outside group that can advocate on your behalf.

Don’t have NC Medicaid? Apply for NC Medicaid.