Medicaid Members

Tailored Plans manage many kinds of care a person needs to be healthy. They are designed for:

• People with serious mental illnesses and substance use disorders
• People with intellectual/developmental disabilities (I/DDs)
• People who are part of the Innovations and Traumatic Brain Injury (TBI) Waiver
• Non-Medicaid behavioral health, intellectual/developmental disabilities, and TBI services for uninsured and underinsured North Carolinians

• Behavioral health care (mental health and substance use disorders)
• Intellectual/developmental disabilities
• Traumatic brain injury
• Physical health care
• Pharmacy services
• Other needs that affect a person’s well-being, like safe housing and enough food

Some benefits are available only by enrolling in the Alliance Health Tailored Plan.

• Expanded mental health services including intensive substance use disorder outpatient services
• Home- and community-based waivers, like the TBI and Innovations Waivers
• Special residential treatment programs for children
• Intermediate care facilities for people with intellectual and developmental disabilities
• Special services for uninsured and underinsured people who need support with mental health, intellectual/developmental disabilities, and substance use disorders

The services and supports available through the Alliance Tailored Plan are offered by a large network of physical and behavioral healthcare providers in communities across the counties we serve. Each one has earned a reputation for successfully serving people with Medicaid or who are uninsured.

Alliance works to be sure members have access to many kinds of effective and innovative care. If a member needs a provider of specialty care not currently available in our network, Alliance will consider out-of-network providers close to them.

These are extra services people can receive outside a doctor’s care that can make their lives healthier and more satisfying, and their homes healthier too. Alliance offers the following supports to eligible Medicaid members to help them reach their disease management goals and keep a healthy environment based on their health care needs:

• Special health camps for young people
• Classes to get a high school degree or learn to read
• Access to a smartphone
• Help to stop using tobacco
• Carpet cleaning (once annually not to exceed $100)
• Special vacuum and replacement filters
• Window or portable air conditioner
• Cooking classes