1915(i) Services
1915(i) services are free Medicaid services to support your independence at home or in the community. 1915(i) services are for people with serious mental illness, severe substance use disorders, traumatic brain injuries or intellectual/developmental disabilities. 1915(i) can help you or a loved one live at home, find a job, learn skills to participate in the community, recover from substance use disorder and more.
What are 1915(i) services?
NC Medicaid 1915(i) services are free for people who qualify.
They help people live on their own at home or in their community.
They are for children and adults with:
- Serious mental health conditions
- Severe substance use disorders
- Intellectual or developmental disabilities
- Traumatic brain injuries
Who is eligible for 1915(i) services?
You may be able to get 1915(i) services if you meet the following requirements:
1. You have an eligible condition
You need support with activities at home or in the community because you have any of the following conditions:
- Serious mental health condition
- Severe substance use disorder
- Intellectual or developmental disability
- Traumatic brain injury
2. You have an eligible plan
These NC Medicaid health plans offer 1915(i) services:
- Alliance Health
- Partners Health Management
- Trillium Health Resources
- Vaya Health
Your plan is listed on your health plan ID card or welcome letter.
Recipients of the NC Innovations Waiver or TBI Waiver are not eligible for 1915(i) services.
How to get 1915(i) services
Call and ask for 1915(i)
Look for the phone number listed on your health plan ID card:
- Alliance Health: 1-800-510-9132, TTY: 711 or 1-800-735-2962
- Partners Health: 1-888-235-4673, TTY:711
- Trillium Health: 1-877-685-2415, TTY: 711
- Vaya Health: 1-800-962-9003, TTY: 711
Or contact your Tailored Care Manager or Care Coordinator if you have one.
Complete An Assessment
A Care Manager will work with you to determine which services best meet your needs.
Get services within 90 days of approval, depending on staff availability.
To get updates on your application, call the number on your health plan ID card or your Tailored Care Manager.
Recipients of the NC Innovations Waiver or TBI Waiver are not eligible for 1915(i) services.
What if I have a different NC Medicaid health plan?
If you have an eligible condition, you can request to move to a Tailored Plan to get 1915(i) services.
Call the NC Medicaid Enrollment Broker at 1-833-870-5500.
1915(i) services are only available with Tailored Plans, NC Medicaid Direct or the Eastern Band of Cherokee Indians Tribal Option.
1915(i) Services for Mental Health
These 1915(i) services are for people with serious mental health conditions. These conditions can cause someone to need help with activities in their home and communities.
Examples can include bipolar disorder, schizophrenia or depression.
- Individual and Transitional Support helps you build life skills to live independently in the community.
- Individual Placement and Support helps you find and keep a job that’s right for you.
- Respite gives caregivers a break, while knowing that their loved one is cared for.
- Community Transition gives you up to $5,000 in credit to help you move from an approved setting to your own home.
1915(i) Services for Intellectual/Developmental Disabilities
These 1915(i) services are for people with intellectual or developmental disabilities. These include teaching skills so people can live more independently and providing respite for caregivers (in or out of the home).
Examples include autism, Down syndrome or fetal alcohol spectrum disorder.
You could get 1915(i) services while waiting for the NC Innovations Waiver.
- Community Living and Supports gives you a trained worker to help with daily activities and life skills.
- Supported Employment helps you find and keep a job that’s right for you.
- Respite gives caregivers a break, while knowing that their loved one is cared for.
- Community Transition gives you up to $5,000 in credit to help you move from an approved setting to your own home.
1915(i) Services for Substance Use
These 1915(i) services are for people with severe substance use disorders. These services include moving out of approved settings such as a state-operated health care facility, a foster or group home, a psychiatric residential treatment facility, a community intermediate care facility (ICF-IID) and to a private home or community.
Examples include misuse of alcohol, cocaine or opioids.
- Individual and Transitional Support helps you build life skills to live independently in the community.
- Individual Placement and Support helps you find and keep a job that’s right for you.
- Respite gives caregivers a break, while knowing that their loved one is cared for.
- Community Transition gives you up to $5,000 in credit to help you move from an approved setting to your own home.
1915(i) Services for Traumatic Brain Injury
These 1915(i) services are for people with traumatic brain injuries. This condition can cause someone to need help with activities in their home and communities. The types of skills taught depend on the person’s own goals.
Examples include a brain injury due to a fall, car accident or sport injury.
- Community Living and Supports gives you a trained worker to help with daily activities and life skills.
- Supported Employment helps you find and keep a job that’s right for you.
- Respite gives caregivers a break, while knowing that their loved one is cared for.
- Community Transition gives you up to $5,000 in credit to help you move from an approved setting to your own home.
What if I have a dual diagnosis?
For example, you may have an intellectual or developmental disability and a serious mental health condition.
If you have a dual diagnosis, you may qualify for 1915(i) services for both diagnoses.
It does not matter which diagnosis is the primary diagnosis.
