NC Medicaid Tailored Plans Launch July 1

More than 210,000 North Carolinians will use Tailored Plans, a new kind of NC Medicaid managed care health plan that supports behavioral health and intellectual/developmental disability needs. 

Starting July 1, 2024, NC Medicaid members with serious mental health or substance issues, an intellectual/developmental disability, or a traumatic brain injury will transition to a Tailored Plan for their Medicaid coverage. Tailored Plans cover doctor visits and prescriptions, as well as behavioral health services to support the health and well-being of members. 

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 (PCP). People who did not pick a PCP by the May deadline were assigned one, which they can change through Jan. 31, 2025. People moving to Tailored Plans should have also received a welcome packet and new member health plan ID card from either Alliance Health, Partners Health, Trillium Health or Vaya Total Care. 

Services available under Tailored Plans include: 

• Home and community-based services 
• Long-term rehabilitation and treatment services, including in-home services  
• Transportation to see your Medicaid doctor and pick up prescriptions 
• Breaks for caregivers, including overnight and weekend care  
• And other benefits, based on the member’s eligibility (see more benefits and services ) 

Visit the NC Medicaid Division of Health Benefits website to know what to expect with the launch of Tailored Plans, including how to make sure your doctors or specialists are covered.

We also have a toolkit of accessible communications that provides more information. The toolkit is available in English and Spanish .