Tailored Plan Medicaid Member Physical Medical Benefits

NC Medicaid provides benefits or health care services covered by your plan. The Tailored Plan provides a number of extra health care services you can get in addition to those you can get through other Medicaid health plans.
 
You must get the services below from the providers who are in Trillium’s network. Services must be medically necessary and provided, coordinated or referred by your primary care provider (PCP).

• Regular Health Care
  • Office visits with your PCP, including regular check-ups, routine labs and tests
  • Referrals to specialists
  • Vision and hearing exams
  • Well-baby care
  • Well-child care
  • Immunizations (shots) for children and adults 
  • Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for members under age 21 
  • Help with quitting smoking or other tobacco use 
• Maternity Care
  • Prenatal, delivery, and post-partum care
  • Childbirth education classes 
  • Professional and hospital services related to maternal care and delivery
  • One medically necessary post-partum home visit for newborn care and assessment following discharge, but no later than 60 days after delivery
  • Care management services for high-risk pregnancies during pregnancy and for 2 months after delivery
• Hospital Care
  • Inpatient care
  • Outpatient care
  • Labs, X-rays and other tests provided, coordinated or referred by your PCP.
• Specialty Care
  • Respiratory care services.
  • Podiatry services. 
  • Chiropractic services.  
  • Cardiac care services.  
  • Surgical services