North Carolina offers Medicaid, a federal and state-funded health insurance program for individuals and families with low incomes and resources. Medicaid provides comprehensive medical coverage, including doctor visits, hospital stays, prescription drugs, and long-term care services. In North Carolina, Medicaid is administered by the Department of Health and Human Services (DHHS) and is known as NC Medicaid. To qualify for Medicaid in North Carolina, individuals must meet certain income and asset limits, as well as citizenship or residency requirements. Medicaid coverage is available to low-income families, pregnant women, children, people with disabilities, people who are blind, and people who are elderly.
Eligibility Requirements for North Carolina Medicaid
To qualify for Medicaid in North Carolina, you must meet certain eligibility requirements. These requirements are based on your income, family size, and other factors. Generally, you must be a resident of North Carolina, a U.S. citizen or qualified non-citizen, and meet income and asset limits. Here are the specific eligibility criteria:
- Income: Your income must be at or below certain limits. These limits vary depending on your family size and the type of Medicaid coverage you are applying for. In general, your income cannot exceed 138% of the federal poverty level (FPL) for most Medicaid programs. For some programs, the income limit may be higher, such as 300% of the FPL for pregnant women and children.
- Assets: You must also meet certain asset limits. These limits vary depending on the type of Medicaid coverage you are applying for. In general, the asset limit is $2,000 for an individual and $3,000 for a couple. Certain assets, such as your home and car, are not counted towards the asset limit.
- Other factors: In addition to income and assets, you must also meet other eligibility factors, such as being a U.S. citizen or qualified non-citizen, being a resident of North Carolina, and not being eligible for other health insurance coverage.
To determine if you are eligible for Medicaid in North Carolina, you can apply online through the state’s Medicaid website, by calling the Medicaid office, or by visiting your local Department of Social Services (DSS) office.
If you are approved for Medicaid, you will receive a Medicaid card that you can use to access covered services. Medicaid covers a wide range of services, including doctor visits, hospital care, prescription drugs, mental health services, and more. The specific services covered by Medicaid vary depending on the type of coverage you have.
Medicaid Programs in North Carolina
Medicaid in North Carolina is offered through various programs:
| Program | Who is Eligible? |
|---|---|
| Medicaid for Children and Pregnant Women | Children under the age of 19 and pregnant women with incomes up to 138% of the federal poverty level (FPL). |
| Medicaid for Adults | Adults aged 19 and older with incomes up to 138% of the FPL, including individuals with disabilities, people who are blind, and people in nursing homes. |
| Medicare Savings Program | Adults aged 65 and older or people with disabilities who are eligible for Medicare and have limited income and assets. |
| N.C. Health Choice for Children | Children under the age of 19 with incomes up to 200% of the FPL who are not eligible for Medicaid. |
| N.C. Health Choice for Adults | Adults aged 19 and older with incomes up to 138% of the FPL who are not eligible for Medicaid. |
. Bullet:
1.
1.
1.
Terminology:
Medicaid
Medicaid
Medicaid
Medicaid
Benefits Covered by North Carolina Medicaid
Medicaid in North Carolina provides comprehensive healthcare coverage to eligible individuals and families with low income. The program covers a wide range of essential healthcare services, including:
- Doctor visits
- Hospital stays
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Dental care
- Vision care
- Hearing aids
- Durable medical equipment
- Home health care
- Long-term care
- Transportation to medical appointments
In addition to these basic benefits, Medicaid in North Carolina also covers a number of optional benefits, including:
- Chiropractic care
- Acupuncture
- Massage therapy
- Physical therapy
- Occupational therapy
- Speech therapy
- Behavioral health services
- Substance abuse treatment
The specific benefits covered by Medicaid in North Carolina vary depending on the individual’s eligibility category. For more information on the benefits covered by Medicaid in North Carolina, please visit the North Carolina Department of Health and Human Services website.
| Category | Eligibility Criteria |
|---|---|
| Children and Pregnant Women | Children under the age of 19 and pregnant women with incomes below 138% of the federal poverty level |
| Adults with Disabilities | Adults with disabilities who are receiving Supplemental Security Income (SSI) or who meet certain other criteria |
| Aged and Disabled Adults | Adults over the age of 65 or who are disabled and have incomes below 138% of the federal poverty level |
| Parents and Caregivers | Parents and caregivers of children who are eligible for Medicaid with incomes below 138% of the federal poverty level |
Managed Care Organizations in North Carolina
North Carolina’s Medicaid program, known as NC Medicaid, provides health coverage to low-income individuals and families. The program is managed through managed care organizations (MCOs) that contract with the state to provide comprehensive health care services to Medicaid recipients.
There are currently five MCOs operating in North Carolina: AmeriHealth Caritas North Carolina, Blue Cross and Blue Shield of North Carolina, Carolina Complete Health, UnitedHealthcare Community Plan of North Carolina, and WellCare of North Carolina.
Each MCO has its own network of providers, including doctors, hospitals, and other health care providers. Medicaid recipients can choose to receive care from any provider in their MCO’s network.
Benefits Covered by NC Medicaid
- Doctor visits
- Hospital stays
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Dental care
- Vision care
- Hearing aids
- Durable medical equipment
- Home health care
- Nursing home care
Eligibility for NC Medicaid
To be eligible for NC Medicaid, individuals must meet certain income and asset requirements. Income limits vary depending on family size and composition. Asset limits are also in place, but they are more flexible than income limits.
How to Apply for NC Medicaid
Individuals can apply for NC Medicaid online, by mail, or in person at their local Medicaid office. The application process is relatively simple and straightforward.
Contact Information for NC Medicaid
For more information about NC Medicaid, individuals can call the Medicaid customer service line at 1-800-662-7030. They can also visit the NC Medicaid website at https://www.ncdhhs.gov/divisions/medicaid.
| MCO | Website | Phone Number |
|---|---|---|
| AmeriHealth Caritas North Carolina | https://www.amerihealthcaritasnc.com | 1-800-443-5976 |
| Blue Cross and Blue Shield of North Carolina | https://www.bcbsnc.com | 1-800-836-1518 |
| Carolina Complete Health | https://www.carolinacompletehealth.com | 1-888-724-4455 |
| UnitedHealthcare Community Plan of North Carolina | https://myuhccp.com/north-carolina | 1-800-664-0951 |
| WellCare of North Carolina | https://www.wellcarenc.com | 1-888-454-1334 |
Hey folks, thanks for stopping by and learning about Medicaid in North Carolina. I hope you found the information helpful. If you still have questions, feel free to drop me a line anytime. In the meantime, keep your eyes peeled for more updates and insights on all things Medicaid in North Carolina. Until next time, stay healthy and take care!