Let's do a quick review and explain what a Tailored Plan is and what you need to know about the Tailored Plan launch that happened on July 1st.
A Tailored Plan is a Medicaid insurance plan that your Local Management Entity/Managed Care Organization (LME/MCO) will operate starting July 1, 2024. The LME/MCO will manage your community-based services and medical services together, along with pharmacy, and long-term supports. The current LME/MCOs are Alliance, Partners, Trillium, and Vaya.
On July 1, 2024, most people with intellectual and developmental disabilities, who qualify for Medicaid, were moved into a Tailored Plan with their current LME/MCO.
You should have received a letter before April 15, 2024 from your LME/MCO giving you instructions on how to make personal choices and how to select a doctor in your LME/MCO’s network.
The choice period ended on May 15, 2024. If you did not call your LME/MCO before May 15th and choose your doctor, they will assign you to a doctor in their network.
Once everyone is assigned a doctor, your LME/MCO will mail you a Welcome Packet. It has a Welcome Letter, Medicaid ID Cards, and a Member Handbook. The packets were mailed out in late May.
If you have not received a welcome packet or you're not sure of the LME/MCO you should work with, click the button below. And you will find more information about Tailored Plans by clicking the button NC DHHS Webpage Tailored Plans.
|