NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans will launch July 1, 2024. Choice period ends on May 15, 2024. Please call to select your PCP. Find PCPs available in our health plan.
For help with non-emergency issues and questions, call Member and Recipient Services Monday through Saturday from 7 a.m. to 6 p.m. Please leave a message if you call us after these hours with a non-urgent request. We will call you back within 1 business day.
If you are in danger or need immediate medical attention, call 911. If you are thinking of hurting yourself or others, or are in emotional or mental pain or distress, call the Behavioral Health Crisis Line at 877-223-4617 at any time, 24 hours a day, 7 days a week. You can speak with someone who will listen and help.
During the Open Enrollment period, the Department closely monitored data indicating the active selections of Tailored Plan-eligible beneficiaries into Standard Plans. None of these beneficiaries were auto-enrolled in a Standard Plan. Toward the end of Open Enrollment, there was an increased uptick in the number of Tailored Plan-eligible beneficiaries who enrolled in a Standard Plan.
Through June 1, approximately 7,000 Tailored Plan-eligible beneficiaries made an active selection to enroll in Standard Plans, which may make them ineligible for services they are currently receiving, have recently received, or may benefit from receiving.
Based on the number and profile of Tailored Plan-eligible beneficiaries who enrolled in a Standard Plan, the Department determined that these beneficiaries would benefit from receiving additional information to ensure they are fully aware of the impact of the decision to leave NC Medicaid Direct and their LME-MCO and enroll in a Standard Plan — including the potential loss of services.
Therefore, the Department will stop Standard Plan enrollments of these beneficiaries and all Tailored Plan-eligible beneficiaries who selected a Standard Planwill remain in NC Medicaid Direct and their LME-MCO through NC Medicaid Managed Care Go-Live on July 1, 2021.
The Department will provide additional information to ensure that these beneficiaries are fully aware of services that may be lost if they move to a Standard Plan. This will include a notice to be sent later this month informing them of the change back to NC Medicaid Direct as well as a detailed list of services that are not available in a Standard Plan.
Beneficiary choice remains paramount and Tailored Plan-eligible beneficiaries will still have the option to enroll in a Standard Plan. The Department plans to implement, by early August, a specific enrollment process for Tailored Plan-eligible individuals that will include enhanced choice counseling to help verify that beneficiaries have all the information they need to understand the impact of their decisions.
We will continue to provide updates on this process and appreciate your ongoing partnership in serving the state’s Medicaid beneficiaries and their families.
Recent News
03/21/2024
Alliance partners with WCPSS to boost youth engagement
In response to challenges in youth engagement and well-being created by the Covid-19 pandemic, Alliance Health, Wake County Public School System and Wake County Cooperative Extension are piloting a community-informed, data-driven strategy to help school staff and re-engage youth in...
Read More
03/19/2024
Alliance Health Partners with NourishedRx to Support Members in TCL Program
Alliance Health announced today that it has entered into a strategic partnership with NourishedRx, a digital health and nutrition company based in Stamford, Connecticut, to support eligible members enrolled in North Carolina’s Transitions to Community Living (TCL) program. The new partnership will enable Alliance...
Read More
02/19/2024
1915C HCBS Innovations Waiver Renewal, July 1, 2024
The NC 1915(c) Home and Community Based Services Innovations Waiver’s current 5-year cycle period will expire on June 30, 2024. NC Medicaid’s goal is to renew the waiver with an effective date of July 1, 2024, for continuity of program planning....
Read More
Was this page helpful?
Members
Providers
Resources
Contact
All provider information and resources have been consolidated into a new section of the website called Provider Central. This section is for health care providers and prescribers only.