Related Q&As
Has the Tailored Plan start date been delayed?
Yes, the start date for full launch of the Tailored Plan has changed from April 1, 2022, to October 1, 2023. (updated 2/27/2023)
Why was the Tailored Plan start date delayed?
The delayed start of Tailored Plans allows Local Management Entity/Managed Care Organizations, which will operate the Tailored Plans, more time to contract with additional providers to ensure a smooth transition for people using the plans and their care providers. Until the Tailored Plans launch, people who will be covered by the Tailored Plans will continue to receive care through their existing plans. (updated 2/27/2023)
Who made the decision to delay the Tailored Plan start date?
NCDHHS (updated 2/27/2023)
If I was enrolled in or chose to enroll in a Tailored Plan, how will I get my health care until October 1, 2023?
You will keep getting health care the way you do now until the new start date. (updated 2/27/2023)
What does Tailored Care Management (TCM) provide?
If you are eligible for TCM, you will have a single care manager who will:
- Coordinate services for physical health, pharmacy benefits, long-term services and supports, behavioral health, traumatic brain injury (TBI) and I/DD-related needs
- Address unmet health-related needs (such as housing, food, transportation, personal safety, employment) by connecting you to local programs and services
- Provide person-centered planning that focuses on your needs and goals
If you are eligible for TCM you will receive a letter with more information in the coming weeks. (updated 10/13)
Will I receive Tailored Care Management (TCM) if I am on the Innovations or Traumatic Brain Injury (TBI) Waiver?
If you are on the Innovations waiver or TBI waiver, you will receive TCM. You can choose your current care coordinator as your TCM provider or choose a different TCM provider. You can call Alliance Member and Recipient Services at 800-510-9132 (Relay 711 or toll-free 800-735-2962, Option 1) to choose a TCM provider or one will be assigned to you. (updated 10/13)
What is the NC Medicaid Ombudsman and how can I reach them?
The NC Medicaid Ombudsman provides education, advocacy and issue resolution for Medicaid beneficiaries in NC Medicaid Managed Care and NC Medicaid Direct. You can use the NC Medicaid Ombudsman resource when you cannot resolve issues with your health plan or your PCP. Go to ncmedicaidombudsman.org or call 1-877-201-3750, Monday through Friday from 8 a.m. to 5 p.m. The call is toll-free. (updated 10/13)
How can I ask questions about the Tailored Plan?
Go to ncmedicaidplans.gov. You can also use the “chat” tool on the website or call NCDHHS at 833-870-5500 (TTY: 711 or RelayNC.com) from 7:00 a.m. to 5:00 p.m., Monday through Saturday. The call is toll-free. Please have your Medicaid ID number when you call or go to the website.
You can get the information at ncmedicaidplans.gov in print. To ask for a free copy, call toll-free at 833-870-5500 (TTY: 711 or RelayNC.com or use the “chat” tool on the website. We will send this information within 5 business days.
You can also call Alliance Member Recipient Services at 800-510-9132 (Relay 711 or toll-free 800-735-2962, Option 1) Monday through Saturday, 7:00 a.m. to 6:00 p.m. (updated 10/13)
What if my address or phone number changes?
Call or visit your local DSS office to report these changes so you don’t miss important Medicaid information. Also notify Alliance Member and Recipient Services at 800-510-9132 Monday through Saturday, 7 a.m. to 6:00 (Relay 711 or toll-free 800-735-2962, Option 1). (updated 10/13)