Provider Outreach to Members

Some providers are encouraging patients to sign up for managed care (i.e. the Standard Plans) and listing the health plans they have contracted with to help patients with health plan selection. We welcome this engagement from our providers, but please note that not all Medicaid members are moving to managed care now. We understand receiving letters or other information from providers to sign up for a health plan is causing some confusion for our members who are not required to sign up at this time.

Members who are not required to sign up include those on the Innovations Waiver or people receiving intensive mental health or substance abuse services.

If you hear from your provider conducting outreach, we encourage you to call the NC Medicaid Enrollment Broker at 833-870-5500 (TTY: 833-870-5588). The enrollment broker can tell you if you are required to sign up for Medicaid Managed Care at this time and can help you with making an informed choice if you are.

Benefit Plans | Service Definitions

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Benefit Plan Information

Service Definitions 

Services for Medicaid–Eligible Children: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

Medicaid covers a broad array of health and dental services for those under age 21. A federal law requires Medicaid to provide all medically necessary health care services to Medicaid-eligible children. This is called Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), which is known in North Carolina as "Health Check." The services are required even if the services are not normally covered by the children's Medicaid.

For more information about Health Check and EPSDT in North Carolina, visit our page Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

 

 

 

Trillium welcomes feedback regarding the current Benefit Plans and Service Definitions. Feedback and recommendations will be taken into consideration and can be sent to QMinfo@TrilliumNC.org.

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