Medicaid Member Plan

Vaya wants to help you and your family get and stay healthy. If you want to quit smoking or are a new mom who wants to learn more about how to best feed your baby, we can connect you with the right program for support. 

Call Member Services at 1-800-962-9003 to learn more about: 

  • Tobacco cessations services to help you stop smoking or using other tobacco products 
  • Women, Infants and Children (WIC) special supplemental nutrition program 
  • Newborn screening program 
  • Hearing screening program 
  • Early intervention program

Tobacco Cessation Services

Quitting smoking or using other tobacco products is one of the most important steps you can take to improve your health. In fact, tobacco use is the number one cause of preventable death in the United States and North Carolina. Smoking causes damage to every system and nearly every organ of the body. 

As a Vaya member, you have extra help through the Quit For Life® Program, which offers extra support at every step in your path to quitting. The program offers free unlimited, one-on-one coaching to help you quit and opportunities for group video sessions and courses through a central digital dashboard that helps you track your progress. 

Quit For Life® also offers nicotine replacement therapies, such as nicotine patches or gum, at no cost to you. Studies show that using nicotine replacement therapies, along with a quit plan and support from a “quit-coach,” make it more likely that people can successfully stop using tobacco products. Vaya members with behavioral health needs or who are pregnant can receive extra support through stress assessments and additional, dedicated coaching teams. 

You can easily access Quit For Life® at any time on your mobile phone or other preferred device for a personalized experience. Quit For Life® is helpful if you are thinking about quitting, ready to quit, or need extra support after relapsing. For more information, call Member Services at 1-800-962-9003. 

Opioid Misuse Prevention Program

Opioids are powerful prescription medications that can be the right choice for treating severe pain. However, opioids may also have serious side effects, such as addiction and overdose. Vaya supports safe and appropriate opioid use through our Opioid Misuse Prevention Program. If you have any questions about our program, call Member Services at 1-800-962-9003. 

Pharmacy Lock-in Program

The Vaya Health Lock-in Program helps identify members who are at risk for possible overuse or improper use of pain medications (opioid analgesics) and nerve medications (benzodiazepines and certain anxiolytics). The Vaya Health Lock-in Program also helps identify members who get the medications from more than one prescriber (doctor, nurse practitioner, or physician’s assistant). If you qualify for this program, Vaya will only pay for your pain medications and nerve medications when: 

  • Your medications are ordered by one prescriber. You will be given a chance to pick a prescriber in the Vaya network. 
  • You have these prescriptions filled from one pharmacy. You will be given a chance to pick a pharmacy in Vaya’s network. 

If you qualify for Vaya Health Lock-in Program, you will be in the program for 2 years. If you do not agree with our decision that you should be in the program, you can appeal our decision before you are placed in the program (see page [page number] for more information on Appeals). 

Specialized Health and Wellness Programs

Vaya also offers specialized programs to help you improve your health and wellness. Call Member  and Recipient Services at 1-800-962-9003 to learn more about programs for: 

  • Diabetes and diabetes prevention 
  • Asthma 
  • High blood pressure 
  • Healthy babies 
  • Maternal health 

Support from Care Management

Managing your health care alone can be hard, especially if you are dealing with many health problems at the same time. If you need extra support to get and stay healthy, we can help. As a member of Vaya’s Tailored Plan, you may be eligible to have a Care Manager on your health care team unless you are getting certain services that already provide care management. 

A Care Manager is a person specially trained in health care who works with you and all your health care providers, including your doctors, to make sure you get the right care when and where you need it. The Care Manager knows what resources are available in your community and will work with local providers to get you the help you need.

For more information, visit Care Coordination | Vaya Health.