How Tailored Care Managers can help you
With Tailored Care Management, you get your own Tailored Care Manager to help you.
Tailored Care Managers are specially trained health care workers who have experience helping people with serious mental illness, substance use disorder, intellectual/developmental disabilities and traumatic brain injury. They help you navigate the health care system to get you what you need.
- Find doctors, dentists and specialists who take Medicaid
- Find treatment programs
- Find services you can get in your home or community
- Schedule appointments and follow-up with your doctors
- Send appointment reminders
- Arrange free rides to and from the appointment
- Help make sure everyone in your care team (like your doctors, specialists and approved family members) is working together
- Help you manage chronic conditions, like diabetes
- Connect you to support groups
- Support you during hospital admissions, discharges and transfers
- Support you during a crisis
- Help you get prescriptions and medical supplies
- Arrange free rides to and from your pharmacy
- Remind you when medications are due
- Help you understand your prescriptions
- Help you get school supports or accommodations, like an Individualized Education Plan (IEP) or 504 Plan
- Support you at school meetings
- Help you find after-school care and summer camps
- Help you find housing resources
- Help you find resources for help with paying your utility bills
- Help you apply for Food and Nutrition Services (food stamps)
- Connect you to job and vocational resources
- Help you understand your rights as an NC Medicaid member
- Help you advocate for your needs
- Help you with the process for complaints and concerns about Medicaid
- Help you complete forms related to Medicaid
- Explain Medicaid changes and how they affect you
- Help you keep your Medicaid benefits
The best way to find out how they can help you is to talk to your Tailored Care Manager.
Ready to get started?
Get Started with Tailored Care Management
Tailored Care Management in action: Kate’s story
Kate had a lot of health issues with her stomach. She began to lose a lot of weight. When she met her Tailored Care Manager, Kate shared that she has had stomach issues for nearly a year.
Because of her mental health, doctors refused to do an endoscopy and treatments she needed. She was upset and did not know what to do. At a certain point, Kate began to lose her vision.
Her Tailored Care Manager found a doctor who was willing to work with Kate. She helped set up a free ride for the appointment.
The doctor found out Kate had a virus that was treatable with antibiotics, and Kate’s health improved.
If you are unsatisfied with your Tailored Care Manager, you can change your Tailored Care Manager or file a complaint with the NC Medicaid Ombudsman.
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:
- Alliance Health, 1-800-510-9132, TTY: 711 or 1-800-735-2962
- Partners Health Management, 1-888-235-4673, TTY/English: 1-800-735-2962, TTY/Spanish: 1-888-825-6570
- Trillium Health Resources, 1-877-685-2415, TTY: 711
- Vaya Health, 1-800-962-9003, TTY: 711
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.