North Carolina Medicaid
Finding the right answers and information about a complicated topic like Medicaid can mean searching through hundreds of pages at government and private websites. Our editors have compiled this digest of North Carolina Medicaid help and resources to assist in your search.
topics: North Carolina Medicaid: North Carolina Public Health Insurance: medical coverage, centers for Medicaid; Medicaid In North Carolina; Medicaid Assistance information; LA; definition Medicaid North Carolina: North Carolina Medicaid Eligibility: Applying for North Carolina Medicaid: Medicaid: Health Programs for Children: North Carolina CHIP:
Topics on this page:
Definitions of Medicaid in North Carolina
Medicaid in North Carolina*
"Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.
Medicaid is a little different, depending on who you are and your situation.
What You Can Expect from Medicaid
- Individuals on Medicaid receive a Medicaid Identification (MID) card, which is their insurance card.
- There are copayments for some services.
- Medicaid has several different types of coverage for people with different needs. For instance,
pregnant women have a special package of benefits all their own.
- To receive Medicaid, you don’t have to go through a physical or other type of exam. However, if you
are applying because you are pregnant, proof of pregnancy is required. You can’t be rejected for
Medicaid because of a health condition you already have. Instead, Medicaid is based on your
family’s finances. You do not have to have a medical need.
- Medicaid managed care provides a medical home if you are
enrolled in Carolina Access or Southcare. Your primary care
provider will help you get the medical services you need.
*source: North Carolina Department of Health and Human Services: NC Division of Medical Assistance , Raleigh, NC 27699-2501
Children's Medicaid in North Carolina
See the section on this page
Health Programs for Children: CHIP: North Carolina
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Medicaid in North Carolina: How It Works; An Introduction to North Carolina Medicaid; What is North Carolina Medicaid?
North Carolina Medicaid Eligibility, How to get Medicaid in North Carolina, Requirements
- brochure:
Medicaid Eligibility Basic Requirements Chart
source:North Carolina Division of Medical Assistance
3 pages; languages: English
from the brochure:
"Recipients of the following cash assistance programs are automatically entitled to Medicaid. No separate Medicaid application or
Medicaid eligibility determination are required. The cash assistance programs are: • Work First Family Assistance – NC program under the federal Temporary Assistance to Needy Families law that provides cash assistance to families with children.
• Supplemental Security Income (SSI) – Federal cash assistance program for...
"
- also from North Carolina Division of Medical Assistance:
web page:
Who is Eligible for Medicaid?
languages: English
from the web page:
"Medicaid serves low-income parents, children, seniors, and people with disabilities. There are different types of coverage for people with different needs. Income and resource limits for each of these groups vary...
"
- web page:
Medicaid Eligibility
source: Centers for Medicare & Medicaid Services
languages: English
Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
- web page:
2011 HHS Poverty Guidelines
source: Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services
languages: English
from the web page:
"...The poverty thresholds are the original version of the federal poverty measure... The poverty guidelines are the other version of the federal poverty measure.
North Carolina Medicaid Citizenship Requirements
- brochure:
Citizenship Documentation Requirements in Medicaid
source:Kaiser Family Foundation
3 pages; languages: English
from the publication:
"Medicaid citizenship requirements
Under federal law, all U.S. citizens and certain legal immigrants who meet Medicaid’s financial and non-financial eligibility criteria are entitled to Medicaid. The Medicaid program has long required states to establish that individuals applying for Medicaid are U.S. citizens or satisfy the immigration restrictions.... "
- brochure:
Medicaid Citizenship Verification Requirement
source:American Public Human Services Association
5 pages; languages: English
from the publication:
"What has changed? In the Deficit Reduction Act of 2005, a new requirement was established with respect to citizenship verification of current and new Medicaid applicants. Citizen applicants were previously able to self-attest their citizenship and identity under penalty of perjury to qualify for Medicaid..... "
Applying for North Carolina Medicaid
- web page:
How to Apply for Medicaid
source:North Carolina Division of Medical Assistance
languages: English
from the web page:
"You may apply at the County Department of Social Services (DSS) in the county where you live. If possible, take the items listed below with you when you go to the DSS office to apply...
"
- also from North Carolina Division of Medical Assistance:
web page:
Medicaid and Health Choice Applications
languages: English
from the web page:
"You may either mail or bring the completed Medicaid Application to the County Department of Social Services (DSS) in the county where you live. This will begin the application process. ...
"
North Carolina Medicaid Offices
- web page:
Local County Directory
source:North Carolina Division of Social Services
languages: English
from the web page:
"North Carolina has 100 counties. Each county has a local Department of Social Services Office. Just select the county that you would like to view phone numbers, physical addresses, and mailing addresses....
"
- hotline:
North Carolina Medicaid Helpline
North Carolina Medicaid Health Plans, HMO, North Carolina Managed Care
Find North Carolina Medicaid Physicians, Doctors
Children's Medicaid: Health Programs for Children: North Carolina CHIP:
What health care programs for children are available in North Carolina?
Children's Medicaid in North Carolina; Medicaid for Infants and Children (MIC):
-
North Carolina Medicaid provides health care coverage for children who meet the requirements based on income, residence, and other criteria. Medicaid for Infants and Children (MIC) provides medical coverage for children under age 19. The income limits are determined by the family size and the age of the child(ren) for whom you are applying. There is also coverage for some individuals under Medicaid for Families with Dependent Children; which provides medical coverage for parent(s) or other caretaker/relative with child(ren) age 18 and under in the household and for children under age 21. A pregnant woman may also qualify.
There is an additional program, which is not Medicaid:
"North Carolina Health Choice (NCHC) for Children is a free or reduced price comprehensive health care program for children. The goal of the NCHC Program is to reduce the number of uninsured children in the State to ensure that the population served will be healthy and ready to learn and work. If your family makes too much money to qualify for Medicaid but too little to afford rising health insurance premiums, your child(ren) may qualify for NCHC."
*source: North Carolina Division of Medical Assistance
What is CHIP?
- "
Originally created in 1997, the Children's Health Insurance Program (CHIP) is a state and federal partnership that provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid but cannot afford to purchase private health insurance coverage. States have considerable flexibility to establish income eligibility rules for CHIP, but children enrolling in the program must be otherwise uninsured.
"
source: InsureKidsNow.gov - Sponsored by the U.S. Department of Health and Human Services.
, Washington, DC
- web page:
(Medicaid) Who is Eligible - Infants, Children, & Families
source:North Carolina Division of Medical Assistance
languages: English,Español
from the webpage:
"Family Planning: Be Smart... Medicaid for Infants and Children... Medicaid for Families with Dependent Children (for parents or other caretakers)... Medicaid for Pregnant Women
Community Alternatives Programs: For children who need long-term care...
"
- also from North Carolina Division of Medical Assistance
:
web page:
Community Alternatives Program for Children (CAP/C)
languages: English
from the web page:
"The Community Alternatives Program for Children (CAP/C) (also known as the Katie Beckett waiver) provides home and community based services to medically fragile children who, because of their medical needs are at risk for institutionalization in a nursing home...
"
- web page:
Baby Love
languages: English,Español
from the web page:
"The Baby Love program is a combination of services designed to help you have a healthy baby. Pregnant and postpartum women are eligible to receive these services...
"
- web page:
Be Smart Family Planning Program
languages: English
from the web page:
"Are you ready to be a mom or dad? Are you ready for another child? Do you think you might want more children? If you answered no to any of these questions, you may qualify to receive birth control methods and health care services for free ...
"
- web page:
What is Health Choice for Children
source:North Carolina Division of Medical Assistance
languages: English
from the web page:
"If your family makes too much money to qualify for Medicaid but too little to afford rising health insurance premiums, your child(ren) may qualify for NCHC... NCHC covers hospitalization and outpatient care including the following...
"
- also from North Carolina Division of Medical Assistance:
web page:
Who is Eligible for Health Choice for Children?
languages: English,Español
from the web page:
"...Your family’s monthly income must be equal to or less than 200% of the federal income limits... If your family’s monthly income is slightly over the income limits listed below, your child(ren) may still be eligible...
"
- web page:
How to Apply for Health Choice for Children
languages: English,Español
from the web page:
"N.C. Health Choice is available only to those children who do not qualify for Medicaid. There is not a separate application for Health Choice. All children who are not eligibile for Medicaid are evaluated for Health Choice...
"
- web page:
Medicaid and Health Choice Applications
languages: English
from the web page:
"You may either mail or bring the completed Medicaid Application to the County Department of Social Services (DSS) in the county where you live....
"
- web page:
North Carolina Health Choice for Children
source:healthinsuranceinfo.net - Georgetown University's Health Policy Institute
languages: English
from the webpage:
"...North Carolina Health Choice for Children is a state-designed program that provides health coverage to low-income children under the age of 19 who are not eligible for Medicaid and who have limited or no health insurance...
"
- publication / brochure:
Children’s Health Coverage:
North Carolina
source:Children's Defense Fund
languages: English
from the web page: "General information about children’s health coverage... - State-based resources, including possible enrollment partners - Steps for enrolling a child in coverage program - Follow-up flyer for parents - Health resources, by county, for children who are not eligible for coverage...
Your child’s coverage will last for 12 months. 60 days before the coverage ends, you will receive a letter asking you for any changes in your family’s residence, income or size. It is very important that you answer these questions and return the forms by the deadline, so your child can keep their coverage..."
- also from Children's Defense Fund:
brochure:
Health Coverage for All Children: North Carolina (October 2009)
2 pages; languages: English
from the brochure:
"How affordable is health coverage for North Carolina’s children? . CHIP eligibility is up to 200 percent of poverty...
„X Medicaid eligibility is 200 percent of poverty for children 0-5, and 100 percent of poverty... for children 6-19...
"
- brochure or publication:
North Carolina MEDICAID FACTS
source:AMERICAN ACADEMY OF PEDIATRICS
languages: English
from the web page:
"Thirty-six percent of North Carolina’s children are enrolled in
Medicaid... The Medicaid program provides health insurance for over 735,000 low-income children in North Carolina. Medicaid is an indispensable health program providing health insurance coverage
"
- Medicaid brochure:
North Carolina Public Health Insurance for Children
source:National Center for Children in Poverty (NCCP)
languages: English, Spanish
from the brochure:
"...The two major federal funding sources for low-income children’s public health insurance are Medicaid and the State Children’s Health Insurance Program (SCHIP). States enjoy some flexibility in their Medicaid programs for children,...
"
- also from National Center for Children in Poverty (NCCP):
web page:
North Carolina Public Health Insurance for Parents
languages: English
from the web page:
"Most family plans are funded through Medicaid, but a handful of states have waivers to use State Children’s Health Insurance Program (SCHIP) funds to cover parents. ...
"
- web page:
North Carolina Demographics of Low-Income Children
languages: English
from the brochure:
"In North Carolina, there are 1,276,256 families, with 2,231,545 children.
Low-Income Children
Low-Income Children: 42% (1,032,646) of children live in low-income families (National: 41%), defined as income below 200% of the federal poverty level..."
- web page:
North Carolina: CHIP Program Name and Type
source:Kaiser Family Foundation statehealthfacts.org
languages: English, Spanish
from the web page:
"Individual state profiles...
"
- web page:
North Carolina Health for Choice for Children
source:GovBenefits.gov - Your Benefits Connection
languages: English
from the webpage:
"...As of October 1998, families who have a total household income that is too high to qualify for Medicaid but too low to afford rising health insurance premiums are able to get free or reduced price comprehensive health care for their children. The new plan, NC Health Choice for Children, provides the same coverage provided for the children of state employees and teachers.
...
"
- web page:
North Carolina Medicaid, SCHIP, & Federal Authority
source:State Coverage Initiatives
languages: English
North Carolina Medicaid Benefits and Coverage: Medicaid Services
- web page:
Pregnancy Medical Home
source:North Carolina Division of Medical Assistance
languages: English
from the web page: "DMA is working in partnership with Community Care of North Carolina (CCNC) and other community stakeholders including providers, local health departments, and the Division of Public Health, to create a program that provides pregnant Medicaid recipients with a pregnancy medical home (PMH). ..."
- brochure or publication:
Women and Medicaid in North Carolina
source:National Women's Law Center
3 pages; languages: English, Spanish
from the brochure or publication:
"Nationally, nearly 17 million nonelderly women— including 10 percent of those living in North Carolina—are covered through Medicaid.1,2 In fact, women comprise the majority (65 percent) of North Carolina’s adult Medicaid beneficiaries....
"
- web page:
Benefits by State: North Carolina (October 2008)
source:Kaiser Family Foundation
languages: English, Spanish
from the web page:
"Medicaid benefits: Online database
"
- brochure or publication:
Mental Health and Substance Abuse Services in
Medicaid and SCHIP in North Carolina (2003)
source: US Dep't of Health and Human Services, Substance Abuse and Mental Health Services Administration
file size: 4 pg.; languages: English
from the brochure:
"As of July 2003, 1,177,033 people were covered under North Carolina's Medicaid/SCHIP programs.
1,076,597 of these were Medicaid beneficiaries and 100,436 were enrolled into the separate SCHIP program. In state fiscal year 2003, North Carolina spent $7.4 billion to provide Medicaid services....
"
Medicaid Prescription Drugs; Preferred Drug List
North Carolina Medicaid Dental Services; Dentist
Other Health Coverage Options in North Carolina
- web page:
Medicaid Deductible
source:North Carolina Division of Medical Assistance
languages: English
from the web page:
"The N.C. General Assembly has established income limits, which county departments of social services use in determining eligibility for Medicaid. These limtis are based on the number of persons in a family. If the income of the family is more than the amount set by the General Assembly, there will be a deductible...
"
- web page:
Search for Health Centers by State or County
source:U.S. Department of Health & Human Services
languages: English
from the brochure:"Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide
•checkups when you're well
•treatment when you're sick
•complete care when you're pregnant
•immunizations and checkups for your children
•dental care and prescription drugs for your family
•mental health and substance abuse care if you need it..."
- brochure:
North Carolina Health Center Fact Sheet
source: National Association of Community Health Centers (NACHC)
languages: English
from the brochure:"North Carolina Federally-Supported Health Centers, 2008"
- also from National Association of Community Health Centers (NACHC):
web page:
Find a Health Center
languages: English
from the web page:
"If you need affordable health care, a Community Health Center may be what you're looking for... Click here to find the health center closest to your address or to see a list of health centers in your state or county/parish...
"
- brochure:
North Carolina Health Care Options Matrix™ Guide
source:Foundation for Health Coverage Education
2 pages; languages: English, Spanish
from the brochure: "...hand-held guide available that outlines your state’s (North Carolina) public and private health care choices for individuals and groups in almost every demographic profile, as well as offers a reference list of phone numbers and Web sites...
"
- brochure:
Consumer Guide for Getting and Keeping Health Insurance in North Carolina
source:Georgetown University Health Policy Institute
file size: 41 pg.; languages: English
from the brochure:
"...As a North Carolina resident, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition. This guide describes your protections as a North Carolina resident. Chapter 1 gives an overview of your protections. Chapters 2 and 3 explain your protections.....
"
North Carolina Medicaid and Nursing Homes, Assisted Living, Home Health Care
- web site:The North Carolina Long Term Care Care Project
North Carolina Medicare Medicaid Nursing Homes Directory
languages: English
from the web page:
"These are North Carolina Nursing Homes in cities A - Z.
" In addition to the state directory described above, there are nursing home directories for principal North Carolina cities. A few examples:
North Carolina Assisted Living
languages: English
from the web page:
"A consumer's guide to information and help about assisted living in North Carolina, with a directory of assisted living facilities...
"
North Carolina Home Health Care Agencies
languages: English
from the web page:
"Directory of North Carolina Home Care Providers and Home Health Agencies, sorted by North Carolina cities. ...
"
North Carolina Medicare / Medicaid Dual Eligibles - Medicare Savings Programs
- web page:
Who is Eligible - Medicaid for Medicare Recipients
source:North Carolina Division of Medical Assistance
languages: English
from the web page:
"Medicare-Aid is a free Medicaid program for people who have Medicare and also have limited income and resources. The program can help pay your Medicare premiums, co-payments and deductibles. It is also known as Medicare Savings Program....
"
- also from North Carolina Division of Medical Assistance:
brochure:
Medicare Savings Programs:
Medicaid Programs to Supplement Medicare
20 pages; languages: English
from the brochure:
"If you are currently receiving Medicare and live in North Carolina, this booklet is for you. In this book you will find information on Medicaid programs that can help pay your Medicare bills. This book will tell you about Medicare Savings Programs, the general requirements, how to qualify, and what the programs cover....
"
en Español : Guía del Usuario para el Programa Medicaid, y Programas para Ahorrar en el Costo de Medicare en Carolina del Norte
"Si usted actualmente está recibiendo beneficios de Medicare y vive en Carolina del Norte, este libro es para usted. En este libro encontrará información sobre los programas del seguro Medicaid que le ayudarán a pagar sus cuentas de Medicare. Este libro le informará de los Programas de ahorro para personas con Medicare, los requerimientos generales, cómo cumplir con los requisitos y lo que los programas abarcan....
"
North Carolina Medicaid Waiver Programs
Report Medicaid Fraud in North Carolina
- web page:
(Medicaid) Fraud and Abuse
source:North Carolina Division of Medical Assistance
languages: English
from the web page: "You are encouraged to report matters involving Medicaid fraud and abuse. If you want to report fraud or abuse, you can remain anonymous; however, sometimes in order to conduct an effective investigation, staff may need to contact you..."
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NC: North Carolina Medicaid: The Medicaid Project, Eligibility, North Carolina Medicaid Rules, Application
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