Tailored Plans - Information for Members

Tailored Plans are made to serve you.

Tailored Plans 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 also serve people who are uninsured through state-funded services, regardless of their diagnosis.

Trillium also serves Medicaid members in NC Medicaid Direct. 

What is changing with the launch of the Trillium Tailored Plan? 

With the Trillium Tailored Plan, we have more ways to serve members, including physical health care and pharmacy needs.

We also have innovative new programs that embrace whole-person care. Here is some important information about the benefits and services covered by the Trillium Tailored Plan: 

• We help schedule Non-Emergency Medical Transportation for members to get to doctors' appointments
• The Behavioral Health Crisis Line and Nurse Line are available to serve Trillium Tailored Plan members.
• Focus on whole person health care and pharmacy services.
• Our provider directory includes physical health care providers.
• Our value-added services offer resources like cell phones or gym memberships that regular benefits do not cover.  
• Unique services (called In Lieu of Services) were created by Trillium and approved by NCDHHS to uniquely meet the needs of our populations.
• The NC Medicaid Ombudsman program provides help with questions and issues you may experience. An ombudsman is an impartial (fair) third party who can help answer questions and resolve issues.
• We help educate about ways to improve well-being through health promotion materials (such as diabetes resources), population health initiatives, and a tobacco cessation program to stop smoking.
• Tailored Care Management is a free service that pairs you with a specially trained health care worker who knows the health care system: a Tailored Care Manager. Your Tailored Care Manager works with you and a team of medical professionals and approved family members or other caregivers to consider your unique health-related needs and find the services you need in your community.