1915(b)(c) Waiver Renewal - public comment open through November 22 and 28, 2018 close

About Medicaid-funded coverage

We contract with providers in our communities to get you the care you need.

Most of our members receive services for IDD and behavioral health conditions through Medicaid. Sometimes there are treatments that may not be covered by Medicaid. We can work with you to look at services that may be available through other types of coverage. Learn about state-funded coverage.

Explore the types of coverage people and families who are Medicaid-eligible below, and call our Access Call Center at 1-800-939-5911 to get started.

Medicaid

Medicaid is a federal health insurance program. If you have Medicaid and live in one of the 20 counties we serve, you are eligible as one of our members to receive support for IDD/MH/SUD related services.

Who is eligible

Standards for Medicaid include:

  • Financial factors, such as income level.
  • Non-financial factors, like family size.

Please note that we do not determine who is eligible to receive Medicaid. You may call our Access Call Center at 1-800-939-5911 to discuss your eligibility and the application process.

How to get started

Your first step is to call our Access Call Center. Our team can help you get started, find a provider, and answer your questions about the process. Just call us at 1-800-939-5911.

More resources

NC Department of Medical Assistance
Applying for Medicaid in North Carolina

 

NC Innovations Waiver


The NC Innovations waiver allows us to help people living with intellectual and/or developmental disabilities (IDD) get extended coverage through Medicaid. It is designed to help you and your family receive services in your home or community.

Who is eligible

To be eligible for NC Innovations Waiver services, you must:

  • Have an IDD diagnosis.
  • Have limitations in three of six major activity areas (self-care, receptive and expressive language, capacity for independent living, learning, mobility, and self-direction and economic self-sufficiency).
  • Need waiver services in order to keep living at home or to move out of an ICF/IDD group home/center.
  • Be eligible for Medicaid.
  • Live in a private living arrangement or a small facility (with no more than six residents).

How to get started

To apply, call our registry department: 1-704-939-7980. We check this voicemail regularly but please allow three business days for a return call.

This waiver has a waitlist due to limited Medicaid funds. We are required to keep the waiver waitlist for our counties, but only the state government has the power to approve new or additional spaces; these spaces are called “slots”. If a slot is not available, we can add you to the waiver's waitlist, also called the “Registry of Unmet Needs.” We know this is frustrating. While you or your loved one wait for a slot on the waiver to open, you may be eligible for other resources.

If you’d like to confirm that you or your loved one are on this waitlist, contact our registry department at 1-704-939-7980.

If you are on the waitlist, it’s very important to keep your contact information updated so that we can reach you. If you have a change of address, phone number, etc., please call our registry department.

More resources

Innovations services at a glance
Innovations services waitlist
Member and family handbook
Supports Intensity Scale
Available services

(b)(3) Services

(b)(3) Services are extra IDD and behavioral health supports for people with Medicaid. They help people with a variety of diagnoses remain in their homes and communities.

About (b)(3) Services

(b)(3) Services are extra IDD and behavioral health supports for people with Medicaid. They help people with a variety of diagnoses remain in their homes and communities.

Who is eligible

To be eligible for (b)(3) Services, you must:

  • Have Medicaid.
  • Have IDD/MH/SUD needs.
  • Meet other requirements specific to each service.

How to get started

Your first step is to call our Access Call Center. Our team can help you get started, find a provider, and answer your questions about the process. Just call us at 1-800-939-5911.

More resources

Overview of (b)(3) services
(b)(3) services booklet
Available services

In Lieu Of

In Lieu Of services are extra supports that may not be covered in the approved Medicaid state plan. Through these service categories, we are able to change or create new services to better meet our members’ needs.

Who is eligible

To be eligible for In Lieu Of services, you must meet certain requirements specific to each service.

How to get started

Your first step is to call our Access Call Center. Our team can help you get started, find a provider, and answer your questions about the process. Just call us at 1-800-939-5911.

More resources

Member and family handbook
Available services

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