Vaya Partners maintains an open network of physical healthcare providers to deliver services through the Vaya Partners Tailored Plan, our Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan for Medicaid members.
The Tailored Plan for Medicaid members include all services required by the North Carolina 1115 Demonstration Waiver and the NC State Plan for Medical Assistance (Medicaid State Plan). An integrated, whole-person health plan, Tailored Plan includes the following physical health service types for Medicaid beneficiaries:
- Primary care
- Urgent care
- Emergency care
- Hospital care
- Children’s screenings
- Women’s healthcare
- Maternity care
- Family planning
- Specialty care
- Personal care services
- Home health services
- Nursing home services
- Hospice care
- Vision care
- Local health department services
- Value-added services for unmet health-related resource needs
For a full list of covered services, see Provider Operations Manual.
All Vaya Partners network providers must be enrolled in NC Medicaid through NCTracks. Vaya Partners contracts with third-party care administrators to manage pharmacy, vision, and other select specialty services. For more information, visit our Provider Enrollment page. Please note that some Medicaid services available to Tailored Plan members are managed by the North Carolina Department of Health and Human Services through the NC Medicaid Direct program. These include dental care, fabrication of eyeglasses, and certain services provided and billed by local education or children’s developmental agencies.