Your Partners NC Medicaid Direct plan gives you the care and support you need to stay healthy.
You get all the regular Medicaid health benefits — like doctor visits, hospital care, prescriptions and behavioral health services — plus special services for people living with mental health, substance use, intellectual or developmental disabilities (I/DD) and traumatic brain injury (TBI).
You may also qualify for added help such as Tailored Care Management, in lieu of services and support for moving from the hospital back to your home and community.
Need help? Call Member and Recipient Services at 1-888-235-4673 (TTY: 1-800-735-2962; Spanish: 1-888-825-6570).
Benefits and Services
The services below are part of your Partners NC Medicaid Direct plan. They are covered when they are medically necessary and provided by doctors, hospitals or other providers in our network. Most services will be coordinated by your primary care provider (PCP). Some services may also need approval (called prior authorization) before you can receive them.
- Community living and support
- Community transition
- Individual and transitional supports
- Respite
- Supported employment services
- Assertive community treatment (ACT)
- Behavioral health crisis and withdrawal management services:
- Facility-based crisis (children/adolescents)
- Mobile crisis management
- Facility-based professional treatment services
- Ambulatory detoxification
- Medically supervised/ADATC detox crisis stabilization
- Non-hospital medical detoxification
- Child and adolescent day treatment
- Community support team (CST)
- Diagnostic assessment
- Early and periodic screening, diagnostic and treatment (EPSDT)
- Multi-systemic therapy
- Intensive in-home
- Inpatient behavioral health
- Outpatient behavioral health emergency department
- Outpatient behavioral health services by direct-enrolled providers
- Partial hospitalization
- Peer support services
- Psychiatric residential treatment facilities (PRTFs)
- Psychological services (health departments, school-based centers)
- Psychosocial rehabilitation
- Residential treatment facilities (children/adolescents)
- Substance use disorder services:
- Outpatient opioid treatment
- Substance abuse comprehensive outpatient treatment (SACOT)
- Substance abuse intensive outpatient program (SAIOP)
- Medically monitored residential treatment
- Non-medical community residential treatment
- Extra help if you have unmet behavioral health, I/DD, or TBI needs
- Support when moving from a hospital stay back home
- Plan created with your providers to meet your needs
- Helps connect you with community resources and local providers
- Acute and Subacute Services (in Institute for Mental Disease)
- Assertive Community Treatment – Step Down (ACT-SD)
- Behavioral Health Urgent Care (BHUC)
- Critical Time Intervention
- Enhanced Crisis Response (ECR, child/adolescent)
- Family Centered Treatment
- High Fidelity Wraparound
- In Home Therapy Services (IHTS)
- Individual Rehabilitation, Coordination and Support Services
- Long-Term Community Supports
- Rapid Care Services
- Rapid Response Bed Therapeutic Foster Care (youth)
- Residential Services – Complex Needs
- Virtual Psychiatric Intensive Outpatient Treatment
- Youth Focused Assertive Community Treatment Team (Youth ACTT)
- Intermediate care facilities for individuals with intellectual disabilities (ICF-IID) (for those who qualify)
- Innovations Waiver services (for those enrolled, or waitlist if no slot)
- Research-based intensive behavioral health treatment for autism spectrum disorder
- A care manager helps you:
- Assess your health needs and set goals
- Arrange appointments and transportation
- Answer medicine questions
- Follow up with providers
- Connect you to community resources
- You can choose or change your Tailored Care Management provider (PCP, Care Management Agency or Partners Care Management)
- You can opt out of Tailored Care Management at any time
Extra Benefits
Pyx Health
Get support for loneliness, depression and overall wellness with the free Pyx Health mobile app for adults 18 and older.
Living Tobacco Free
Receive tools, coaching and resources to help you quit tobacco and improve your health.
GreatDAY Rewards
GreatDAY Rewards is Partners’ program that thanks you for taking steps to stay healthy.
Members can earn up to $75 each year from all GreatDAY Rewards combined.
Eligibility may vary by program.
Call Partners Member and Recipient Services at 1-888-235-4673 (Relay NC 711) for help with questions.
Annual Wellness Visit
Complete your yearly wellness check-up and earn a $20 gift card. An annual wellness visit helps check your overall health, spot risks for certain conditions and connect you to resources that keep you healthy.
- To qualify, visit your primary care provider for your annual wellness appointment.
- After your visit, provide your visit summary to Partners.
- Supporting documentation is required.
- One reward per year.
Care Needs Screening
- Earn a $25 gift card when you complete your Care Needs Screening.
- The screening is short and helps Partners learn about your health needs so we can better support your care.
- A Partners staff member or your Tailored Care Manager will contact eligible members to complete it.
- Need help reaching your care manager? Call Member Services at 1-888-235-4673.
- Supporting documentation is required.
- One reward per year.
Prenatal Visits (StrongSTART)
- Earn up to $75 in gift cards by keeping up with your prenatal visits. Each completed visit is worth $25, claimable during pregnancy and up to 6 months postpartum.
- Rewards are for members who notify Partners of their pregnancy.
- Must be engaged in prenatal care and provide proof of visits.
- Limit of 3 rewards per pregnancy (maximum $75).
Pyx Health App Enrollment
- Download and sign up for the Pyx Health app to earn a $10 gift card. The app provides daily check-ins, resources and support for your mental and physical health.
- Must be age 18 or older to participate.
- Register with your Partners or Medicaid ID at HiPyx.com.
- Use your smartphone, answer a few questions and start using the app.
- Call Pyx Health at 1-855-499-4777 if you need help registering.
- After registering, complete the GreatDAY Reward Form to claim your reward.
