Yes, the start date for full launch of the Tailored Plan has changed from December 1, 2022 to April 1, 2023. (updated 10/13)
Pushing back the full launch of the Tailored Plans will allow more time for Alliance and the other LME/MCOs to contract with all providers necessary to support member choice for primary care providers (PCPs) and other healthcare professionals. (updated 10-13)
NCDHHS made the decision in consultation with the six North Carolina LME/MCOs. (updated 10-13)
You will keep getting health care the way you do now until the new start date. (updated 10/13)
While the start of Tailored Plans has changed to April 1, 2023, Tailored Care Management will begin on December 1, 2022. (updated 10/13)
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)
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)
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 8:00 a.m. to 5:00 p.m. The call is toll-free. (updated 10/13)
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)
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, 7:00 a.m. to 6:00 p.m (Relay 711 or toll-free 800-735-2962, Option 1). (updated 10/13)