Behavioral Health and Intellectual/
Developmental Disabilities Tailored Plan
At Vaya, we believe your unique needs should always be at the center of your care.
Vaya Total Care
If you already receive services and supports from Vaya Health, there is a new way to receive this care – and more. People with serious mental health conditions, severe substance use disorders, I/DD, or traumatic brain injuries (TBI) are able to also receive physical health services and pharmacy benefits under a single plan: Vaya Total Care.
Vaya Total Care is a Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan focused on whole-person care. Under this plan, you continue to receive care from behavioral health providers in our provider network, but also have access to doctors and specialists, pharmacy benefits, care managers, and long-term services and supports. Vaya Total Care is designed to make decisions easier, improve outcomes, and help members achieve better overall health and well-being through one plan and one point of contact.
NC Medicaid Services
For Medicaid beneficiaries with serious mental illness, serious emotional disturbance, severe substance use disorder, intellectual/ developmental disabilities (I/DD), or a traumatic brain injury (TBI):
- Physical health care services
- Pharmacy benefits
- Mental health services
- Substance use recovery services
- Intellectual/developmental disabilities (I/DD) services
- NC Innovations Waiver services
- Traumatic Brain Injury (TBI) services
- Long-term services and supports (LTSS)
- Dedicated care manager
Your Path to Better Health
Your health journey may not always be a straight line, but we are here to keep you moving forward. As a trusted partner, we will make sure you get the kind of care you need for the challenges you face. Our commitment to whole-person care helps you on your path forward. It’s all to make your health journey more rewarding and easier to navigate. After all, when we work together to help people reach their potential, we all benefit.
The way people get Medicaid services has changed – not the eligibility or services themselves. The focus is managing all of a person’s health needs through broader and more effective care management that addresses both physical and behavioral health as well as social factors that can impact health.
A Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan is a North Carolina Medicaid health plan. It offers physical health, pharmacy, care management and behavioral health services. It is for members and recipients who may have significant mental health needs, severe substance use disorders, intellectual/developmental disabilities (I/DD) or traumatic brain injuries (TBI).
Vaya Total Care is a Tailored Plan with services and supports for behavioral health, I/DD, TBI, physical health, prescription medications, long-term services and supports, and unmet health-related resources.
No, as long as your behavioral health or I/DD provider is in Vaya’s Provider Network you do not need to make a change.
If your provider is not contracted with Vaya, we will work to get a contract or Out-of-Network Agreement with them if possible.
As long as your provider is in Vaya’s Provider Network, you do not have to make a change.
If you have already chosen a PCP, you do not need to do anything.
If you have not chosen a PCP, you will be able to select a PCP.
If you do not choose a PCP, one will be automatically assigned to you.
We are working to contract with all physical health and pharmacy providers enrolled in NC Medicaid. If your provider is not contracted with Vaya, we will work to get a contract with them if possible.
Vaya Total Care is available to members who get their Medicaid from 32 counties in North Carolina. If you meet certain criteria, you will be automatically enrolled in Vaya Total Care. The North Carolina Enrollment Broker can help you with questions.
Phone Number: 1-833-870-5500
TTY: 1-833-870-5588
Website: ncmedicaidplans.gov
Mobile App: NC Medicaid Managed Care Mobile App
You can always call our Member and Recipient Service Line at 1-800-962-9003 ( for help with non-emergency questions, issues, or concerns.)
If a member chooses to change their Tailored Care Management provider or opt out of Tailored Care Management, there are two ways to request this:
- Call the Vaya Member and Recipient Service line at 1-800-962-9003 ( for help with non-emergency questions, issues, or concerns.)
- Download and fill in the Tailored Care Management Opt Out / Change form from our website. Instructions on how to submit the form are available on the first page.
Resources
NC Medicaid Enrollment Broker Call Center is available at 1-833-870-5500 (TTY: 833-870-5588), Monday through Sunday 7 a.m. to 8 p.m. or visit ncmedicaidplans.gov.
For more information from the NC Department of Health and Human Services, visit the Medicaid Transformation and Behavioral Health I/DD Tailored Plan webpages.
