Tailored Plans - Information for Members
Tailored Plans are made to serve you.
Tailored Plans are specifically designed to serve the complex needs of individuals with significant behavioral health disorders, intellectual and developmental disabilities, and traumatic brain injury — populations Trillium and all other LME/MCOs have long served. The Tailored Plans will also serve uninsured individuals currently receiving state-funded services, regardless of their diagnosis.
Some members will remain in NC Medicaid Direct; please follow any instructions in the letters you will get later this year.
Tailored Plan Information Session
Live, Virtual Information Session for Members & Recipients
Please view recordings from our previous information sessions.
For Members: recorded videos will be posted soon
- Choosing a PCP, How to change PCP, and Auto-enrollment
- Requesting a new Medicaid card or other materials; How to receive information
- New providers and services for individuals with Medicaid coverage
February 23, 2023
Trillium Advantage and Value-Added Services, Health Promotion and Prevention Programs
February 16, 2023
What is the NC Medicaid Ombudsman Program?
November 21, 2022
Session - Changes in Tailored Care Management - 1915i information
Questions & Answers
June 30, 2022
Session Members and Recipients
Questions & Answers
While Trillium currently coordinates services for behavioral health and I/DD needs, with the launch of the Trillium Tailored Plan, we will also serve members with physical health care and pharmacy needs.
With the launch of the Trillium Tailored Plan, we will start exciting new programs and embrace whole-person care. Here are a few changes you will see:
- New terms, including Medicaid members and State-funded recipients; there will be separate handbooks for members and recipients to review appropriate information and requirements.
- We will help schedule Non-Emergency Medical Transportation for members to get to doctors appointments
- The launch of our Nurse Line.
- New benefits listed on our website for physical health care and pharmacy services.
- An updated provider directory that will include physical health care providers.
- New value-added and in lieu (pronounced “loo”) of services that are created by Trillium and approved by NCDHHS to uniquely meet the needs of our populations.
- NC Medicaid Ombudsman program where you get help with questions and issues. An ombudsman is a third party who can help answer questions and resolve issues.
- New ways to improve your well-being through health promotion materials (such as diabetes information), health prevention, and a program to stop smoking.
Medicaid members do not need to do anything at this time. We will soon start sharing opportunities for members to learn about changes to procedures, new services available, and what to expect. Please follow these pages, sign up to receive our emails, and let your care manager know if you would like to opt in to receive text messages.
Members will be able to request transition to the Trillium Tailored Plan if they have been placed on the Standard Plan and choose to be served by the Trillium Tailored Plan. Members who use certain services for their I/DD, behavioral health, or TBI, (for example, need access to State-funded or B3 services, are on Innovations Waiver, OR are on the Innovations waiting list) may choose to ask to be served through the Trillium Tailored Plan. Forms to request to stay with the Tailored Plan can also be found on the enrollment broker’s website.