1 / 5

**Transition to Tailored Plan: Policy Guidelines & Enrollment Process**

Explore the guidelines and process for transitioning beneficiaries to the Behavioral Health I/DD Tailored Plan. Learn about eligibility criteria, auto-enrollment in Standard Plans, and the timeline leading up to the launch. Stay informed to ensure continued coverage.

reagle
Download Presentation

**Transition to Tailored Plan: Policy Guidelines & Enrollment Process**

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Add a Slide Title - 1 Nov 2019 Source https://files.nc.gov/ncdhhs/BH-IDD-TP-FinalPolicyGuidance-Final-20190318.pdf In the months leading up to Behavioral Health I/DD Tailored Plan launch, the Department will reassess Behavioral Health I/DD Tailored Plan eligibility for beneficiaries who were previously identified as meeting the Behavioral Health I/DD Tailored Plan eligibility criteria based on a more recent lookback period. Those beneficiaries who no longer meet the Behavioral Health I/DD Tailored Plan eligibility criteria (e.g., do not have the required diagnosis and/or service utilization in the relevant look-back period) will be auto-enrolled in Standard Plans. All Beneficiaries Plans remain in place until 7/2021 deadline. State Legislator authorized final policy governing the creation of the Tailored Plan. Nov 2019—July 2021 The Department of Health & Human Services with begins working with the State General Assembly to design the Tailored Plan. March 2019 July 2021 2017 Auto-Enrollment for those already receiving Innovations. BH/IDD Plans Start Standard Plan Launch Date for Non-Innovations Beneficiaries Tailored Plan Idea is Formed Get plugged in! June 2018 The Bottom Line: After July 2021 some who were eligible for Innovations will not be eligible for the Tailored Plan, but many will retain their eligibility. Stay on top of eligibility requirements, policy updates, and contact your State Rep.

  2. Add a Slide Title - 1 https://www.ncleg.gov/RnR/Representation Results of Policy were the Creation of Guiding Principles Medicaid Eligibility Requirements Tailored Plan Eligibility Process for TP Enrollment Transition between SP & TP Benefits Covered Under TP e All Beneficiaries Plans remain in place until 7/2021 deadline. State Legislator authorized final policy governing the creation of the Tailored Plan. Nov 2019—July 2021 The Department of Health & Human Services with begins working with the State General Assembly to design the Tailored Plan. July 2021 June 2018 2017 Auto-Enrollment for those already receiving Innovations. BH/IDD Plans Launch for all Standard Plan Launch Date for Non-Innovations Beneficiaries Geographic Regions are Determined 6 Tailored Plan Idea is Formed Find your State Legislator online. Nov 2019 March 2019

  3. Bottom Line: If you are already enrolled in Innovations services you will get to choose between the Standard Plan and Tailored Plan. https://files.nc.gov/ncdhhs/BH-IDD-TP-FinalPolicyGuidance-Final-20190318.pdf Tailored Plans Cover: Tailored Plans, targeted to serve special populations with unique health care needs. This will include a behavioral health and intellectual/developmental disability Tailored Plan, which will provide integrated physical health, behavioral health, intellectual and developmental disability (I/DD) and pharmacy services to enrollees with significant behavioral health and I/DD needs. • Standard Plans, which will cover physical, behavioral and pharmacy services for most Medicaid and NC Health Choice beneficiaries, • Standard Plan Covers: • Physical Healthcare • Behavioral Health Services • Pharmacy Services Tailored Plans Cover More Services for IDD

  4. Template editing instructions and feedback

More Related