Tailored Plan Launch is Delayed
NC Medicaid will delay Tailored Plan Launch beyond October 2023. A new launch date has not been announced.
More information can be found 
Learn about Tailored Plan here

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Medicaid expansion will no longer launch Oct. 1 as the North Carolina General Assembly failed to take needed action to meet that date. A new launch date will be announced following the needed legislative action, but it will not be Oct. 1.
For more information, please view the press release from NCDHHS.


Member Benefit Plans | Service Definitions

Trillium coordinates services for Medicaid members in NC Medicaid Direct, and state-funded recipients. Services listed here will be either for members, recipients, or both as noted.

Trillium coordinates the following plans:

  • State-funded Recipients: for those who do not have insurance.
  • NC Medicaid Direct: for those who are on Medicaid but are not in the Tailored Plan. NC Medicaid will issue your Medicaid ID card.    

Please note: Physical health and pharmacy services and some other services (such as 1915i) will not be available until Oct. 1, 2023. 

Medicaid ID card

Medicaid ID card

Intellectual Developmental Disability (I/DD) and Traumatic Brain Injury (TBI) Benefits

Trillium covers special services for individuals with intellectual and developmental disabilities that include Intermediate care facilities for individuals with intellectual disabilities (ICF/IID) and Innovations waiver services for people, enrolled in the NC Innovations Waiver.

NC Innovations Waiver services support individuals with intellectual and developmental disabilities to live the life they choose. Individuals get services in their homes or community. 

The services covered by Trillium include:

Mental Health/Substance Use (MH/SU) Benefit Plan

Behavioral health care includes mental health (your emotional, psychological and social well-being) and substance (alcohol and other drugs) use disorder treatment and rehabilitation services. All members have access to services to help with mental health issues like depression or anxiety or to help if they are abusing drugs. 

The services covered by Trillium include:

Medicaid In Lieu of Services (ILOS)

Please note: The new ILOS services are not available until the Tailored Plan launch.

Trillium's Current ILOS services are available until Tailored Plan launch.   

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

Services for Medicaid–Eligible Children: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) - Trillium covers services, products, or procedures for a Medicaid member under age 21 if the service is medically necessary to correct a defect, physical or mental illness, or a condition or health problem identified through a screening examination.

Service Definitions

Utilization Management

Trillium's Utilization Management (UM) Department reviews all treatment authorization requests for members or recipients in our region. 

UM decisions are made by qualified health professionals. Trillium’s licensed clinicians and behavioral healthcare professionals gather only relevant and necessary clinical information to make decisions about the medical necessity of requests. “Medical necessity” means necessary for the treatment or diagnosis of a health condition. 

For more information on our Clinical Review Criteria and Utilization Management Program Policy.

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