Medicaid is a state-federal health insurance program that provides coverage to low-income individuals and families. In North Carolina, the income limit for Medicaid varies depending on the type of coverage and the size of the household. For example, in 2023, the income limit for a single adult to qualify for regular Medicaid is 138% of the federal poverty level (FPL), which is $18,754 per year. For a family of four, the income limit is 200% of the FPL, which is $55,500 per year. There are also income limits for specific Medicaid programs, such as the Children’s Health Insurance Program (CHIP) and the Medicare Savings Program.
Medicaid Income Eligibility Guidelines
Medicaid is a government-funded health insurance program that provides coverage to low-income individuals and families. In North Carolina, the income limit for Medicaid varies depending on the type of coverage you are applying for and your family size. The following are the Medicaid income eligibility guidelines for North Carolina:
Income Limit for Medicaid in North Carolina
- Medicaid for Pregnant Women: 138% of the federal poverty level (FPL)
- Medicaid for Children: 200% of the FPL
- Medicaid for Parents and Caretaker Relatives: 185% of the FPL
- Medicaid for Adults without Children: 138% of the FPL
- Medicaid for People with Disabilities: 138% of the FPL
- Medicaid for People Receiving Supplemental Security Income (SSI): No income limit
To determine if you are eligible for Medicaid in North Carolina, you must apply through the state’s Medicaid application process. You can apply online, by mail, or in person at your local Department of Social Services (DSS) office. The DSS office will review your application and determine if you meet the Medicaid income eligibility guidelines.
If you have any questions about the Medicaid income eligibility guidelines in North Carolina, you can contact your local DSS office or visit the North Carolina Department of Health and Human Services website.
Medicaid Income Eligibility Guidelines – Table
| Type of Coverage | Income Limit |
|---|---|
| Medicaid for Pregnant Women | 138% of the FPL |
| Medicaid for Children | 200% of the FPL |
| Medicaid for Parents and Caretaker Relatives | 185% of the FPL |
| Medicaid for Adults without Children | 138% of the FPL |
| Medicaid for People with Disabilities | 138% of the FPL |
| Medicaid for People Receiving Supplemental Security Income (SSI) | No income limit |
What is Medicaid?
Medicaid is a government-sponsored health insurance program for low-income individuals and families. It covers a wide range of medical services, including doctor visits, hospital stays, prescription medications, and mental health care. Medicaid is jointly funded by the federal government and the states, and each state has its own eligibility requirements and benefits.
Factors Affecting Medicaid Eligibility
In North Carolina, Medicaid eligibility is based on several factors, including:
- Income
- Age
- Disability
- Pregnancy
- Family composition
For most programs, the income limit is 138% of the federal poverty level (FPL). This means that a family of four with an income of less than $36,156 per year is eligible for Medicaid. However, there are some exceptions to this rule. For example, children under the age of 19 and pregnant women are eligible for Medicaid regardless of their income. Additionally, people with disabilities may be eligible for Medicaid even if their income is above the limit.
Income Limits for Medicaid in North Carolina
The following table shows the income limits for Medicaid in North Carolina for different family sizes:
| Family Size | Income Limit |
|---|---|
| 1 | $17,658 |
| 2 | $23,796 |
| 3 | $29,934 |
| 4 | $36,156 |
| 5 | $42,378 |
| 6 | $48,594 |
| 7 | $54,810 |
| 8 | $61,026 |
How to Apply for Medicaid in North Carolina
If you think you may be eligible for Medicaid, you can apply online or by mail. You can also apply at your local Department of Social Services office. The application process is free, and you will need to provide proof of your income, assets, and family size. Once your application is processed, you will be notified of your eligibility status.
How Do I Apply for Medicaid in North Carolina?
Applying for Medicaid in North Carolina can be done by either contacting your local Department of Social Services (DSS) office in person, by phone, by mail, or online. You can apply on your own behalf or have someone, such as a family member or friend, help you. You can also apply for Medicaid coverage for someone else, such as a child or spouse.
You will need to provide the following information when applying for Medicaid in North Carolina:
- Your name, address, and date of birth
- Your Social Security number
- Your income and assets
- Information about your disability (if you are applying for disability-related Medicaid)
- Information about your family members (if you are applying for Medicaid for a child or a pregnant woman)
Once you have submitted your application, the DSS office will review it to determine if you are eligible for Medicaid coverage. If you are eligible, you will be sent a Medicaid card. You can use your Medicaid card to access health care services at any Medicaid-participating provider.
If you are denied Medicaid coverage, you can appeal the decision. You can find more information about appealing a Medicaid denial decision by contacting your local DSS office.
You can find more information about Medicaid in North Carolina by visiting the NC Medicaid website. The website has information about eligibility requirements, how to apply for Medicaid, and how to use Medicaid coverage.
Other Information
Here are some additional things to keep in mind about Medicaid in North Carolina:
- Medicaid is a health insurance program for people with low incomes and limited resources.
- Medicaid covers a wide range of health care services, including doctor visits, hospital stays, prescription drugs, and mental health care.
- Medicaid is funded by the federal government and the state of North Carolina.
- The income limit for Medicaid in North Carolina is 138% of the federal poverty level (FPL).
- You can apply for Medicaid online, by phone, or in person at your local DSS office.
- If you are approved for Medicaid, you will receive a Medicaid card that you can use to access health care services.
| Family Size | Annual Income Limit |
|---|---|
| 1 | $17,655 |
| 2 | $23,796 |
| 3 | $29,937 |
| 4 | $36,078 |
| 5 | $42,219 |
| 6 | $48,360 |
| 7 | $54,501 |
| 8 | $60,642 |
Medicaid Coverage and Benefits
Medicaid is a health insurance program jointly funded by the federal and state governments that provides coverage for low-income individuals and families. In North Carolina, Medicaid provides comprehensive coverage, including:
- Doctor visits
- Hospitalization
- Prescription drugs
- Mental health services
- Dental care
- Vision care
Medicaid also provides coverage for long-term care services, such as nursing home care and home health care. To qualify for Medicaid in North Carolina, individuals must meet certain income and asset limits. The income limits vary depending on the type of Medicaid coverage being sought.
The income limit for Medicaid in North Carolina is based on the federal poverty level (FPL). For 2023, the FPL for a single person is $13,590 and for a family of four is $27,750. Medicaid eligibility is determined by comparing an individual’s or family’s income to the FPL. Individuals and families with incomes below the FPL are generally eligible for Medicaid coverage. However, there are some exceptions to this rule. For example, pregnant women and children under the age of 19 are eligible for Medicaid coverage regardless of their income.
In addition to income, Medicaid eligibility is also based on assets. Assets are defined as anything of value that an individual or family owns. Some examples of assets include cash, stocks, bonds, and real estate. The asset limit for Medicaid in North Carolina is $2,000 for single individuals and $3,000 for families. Individuals and families with assets above these limits are not eligible for Medicaid coverage.
| Type of Coverage | Income Limit |
|---|---|
| Medicaid for pregnant women | 138% of the FPL |
| Medicaid for children under 19 | 138% of the FPL |
| Medicaid for adults | 138% of the FPL |
| Medicaid for people with disabilities | SSI income limit |
| Medicaid for people over 65 | 135% of the FPL |
Hey folks, I hope this article helped shed some light on the income limits for Medicaid in North Carolina. I understand that navigating government programs can be a bit confusing, but I’m here to tell you that you’re not alone. If you have any further questions or concerns, feel free to reach out to your local Medicaid office. And remember, knowledge is power, so keep yourself informed and stay up-to-date on all the latest changes and updates. Thanks for reading, and I’ll catch you next time with more helpful information. Take care, y’all!