Tailored Plan

What is a Tailored Plan?

A Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plan (Tailored Plan) is a North Carolina Medicaid health plan. It offers physical health, pharmacy, care management and behavioral health services. It is for members with mental health needs, substance use disorders, intellectual/developmental disabilities (I/DDs) or traumatic brain injuries (TBIs). Tailored Plans offer added services for members who qualify.

Tailored Plans will start at a later date.

Who qualifies for a Tailored Plan?

People who get Innovations Waiver services
People who get Traumatic Brain Injury (TBI) Waiver services
People who may have a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI).
Tailored Plan services
Tailored Plans offer the same services as Standard Plans.

Tailored Plan services not offered by Standard Plans

Tailored Plans offer certain services that Standard Plans don’t have. These include services for a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI), such as:

Assertive community treatment
Child and adolescent day treatment services
Community support team (CST)
Intensive in-home services
Multi-systemic therapy services
Psychiatric residential treatment facilities (PRTFs)
Psychosocial rehabilitation
Residential treatment facility services
Substance abuse comprehensive outpatient treatment program (SACOT)
Substance abuse intensive outpatient program (SAIOP)
Substance abuse medically monitored residential treatment
Substance abuse non-medical community residential treatment
These services may also be offered by NC Medicaid Direct if you qualify.

Services only offered by Tailored Plans

Innovations Waiver services
Intermediate Care Facility for individuals with Intellectual Disabilities (ICF-IID) services
State-funded (non-Medicaid) services
TBI Waiver services
Transitions to Community Living (TCL) program services