Your Path Our Purpose

Behavioral Health & 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. Beginning April 2023, people with significant mental health conditions, substance use disorders, intellectual/developmental disabilities (I/DD), or traumatic brain injury (TBI) will be able to also receive physical health services and pharmacy benefits under a single plan: Vaya Total Care. 

A young girl about three years old sits on the lap of her father. They are sitting across from a doctor in a white coat. 

Vaya Total Care is a Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan focused on whole-person care. Under this plan, you will continue to receive care from behavioral health providers in our provider network, but will 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

Available on April 1, 2023

Learn more

State-Funded Services

For qualifying North Carolina residents with no insurance, or not enough insurance:

  • Mental health services
  • Substance use recovery services
  • I/DD services
  • TBI services

Available on April 1, 2023

Learn more

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.

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Frequently Asked Questions

What is changing about North Carolina Medicaid health care?

The way people get Medicaid services is changing – 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.

What is a Tailored Plan?

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.

Will my existing Medicaid benefits change? 

No.

Will I have to change my behavioral health or I/DD providers?

No, as long as your behavioral health or I/DD provider is in Vaya’s Provider Network you will not need to change your behavioral health or I/DD provider.

If your provider is not contracted with Vaya, we will work to get a contract or Out-of-Network Agreement with them if possible.

Will I have to change my primary care provider (PCP), doctors, or specialist?

As long as your provider is in Vaya’s Provider Network, you will not have to 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 before Tailored Plans start.

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.

How do I enroll in Vaya Total Care?

Vaya Total Care is available to members who get their Medicaid from 31 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.

Website: ncmedicaidplans.gov

Mobile App: NC Medicaid Managed Care Mobile App

You can always call our Member & Recipient Services Line at 1-800-962-9003 Monday through Saturday 7 a m to 6 p m for help with non-emergency questions, issues, or concerns.

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.

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