Medicaid is a public health insurance program that provides coverage to low-income individuals and families. In North Carolina, Medicaid coverage is available to people who meet certain income and eligibility requirements. These include pregnant women, children, individuals with disabilities, and people who are elderly or blind. Additionally, some other people may be eligible for Medicaid coverage, such as people who need long-term care or people who are receiving certain types of medical treatment. Medicaid coverage in North Carolina is provided through a variety of programs, including Medicaid, NC Health Choice, and the Children’s Health Insurance Program (CHIP).
Eligibility Criteria for Medicaid in North Carolina
Medicaid is a health insurance program that is jointly funded by the federal government and the states. In North Carolina, Medicaid provides coverage to low-income individuals and families, as well as to certain groups of people with disabilities or special needs. To be eligible for Medicaid in North Carolina, you must meet certain income and other eligibility requirements.
Income Limits
The income limits for Medicaid in North Carolina vary depending on the type of coverage you are applying for. For most types of Medicaid, the income limit is 138% of the federal poverty level (FPL). The FPL is a measure of poverty that is used to determine eligibility for many government programs. For 2023, the FPL is $1,359 per month for a single person and $2,775 per month for a family of four.
There are some exceptions to the income limits. For example, pregnant women and children under the age of 19 are eligible for Medicaid regardless of their income. Additionally, people with disabilities or special needs may be eligible for Medicaid even if their income is above the limit.
Other Eligibility Requirements
In addition to meeting the income limits, you must also meet other eligibility requirements to qualify for Medicaid in North Carolina. These requirements include:
- You must be a resident of North Carolina.
- You must be a U.S. citizen or a qualified immigrant.
- You must not be eligible for Medicare.
- You must not be incarcerated.
There are some exceptions to these requirements. For example, children who are not U.S. citizens or qualified immigrants may still be eligible for Medicaid if they meet the other eligibility requirements.
How to Apply for Medicaid
To apply for Medicaid in North Carolina, you can contact the North Carolina Department of Health and Human Services (DHHS). You can also apply online through the DHHS website. The application process can take several weeks, so it is important to apply as early as possible.
| Category | Income Limit | Other Requirements |
|---|---|---|
| Adults | 138% of FPL | Must be a resident of North Carolina, must be a U.S. citizen or qualified immigrant, must not be eligible for Medicare, must not be incarcerated |
| Children | No income limit | Must be a resident of North Carolina, must be a U.S. citizen or qualified immigrant, must not be eligible for Medicare, must not be incarcerated |
| Pregnant Women | No income limit | Must be a resident of North Carolina, must be a U.S. citizen or qualified immigrant, must not be eligible for Medicare, must not be incarcerated |
| People with Disabilities | Varies | Must meet the income limits for the specific disability program, must be a resident of North Carolina, must be a U.S. citizen or qualified immigrant, must not be eligible for Medicare, must not be incarcerated |
Income Limits for Medicaid Eligibility in NC
Medicaid is a government-sponsored health insurance program that provides coverage to low-income individuals and families. To be eligible for Medicaid in North Carolina, you must meet certain income and other requirements. The income limits for Medicaid eligibility in NC vary depending on your household size and composition.
- For individuals: The income limit is 138% of the federal poverty level (FPL).
- For families: The income limit is 138% of the FPL for the family size.
- For pregnant women: The income limit is 185% of the FPL.
- For children under 19: The income limit is 200% of the FPL.
You can also qualify for Medicaid if you are:
- Blind
- Disabled
- Caring for a child under 6 years old
- Pregnant
- A member of a low-income family
| Household Size | 138% of FPL | 200% of FPL |
|---|---|---|
| 1 | $17,657 | $25,520 |
| 2 | $23,792 | $34,310 |
| 3 | $29,927 | $43,099 |
| 4 | $36,062 | $51,889 |
| 5 | $42,197 | $60,679 |
| 6 | $48,332 | $69,468 |
| 7 | $54,467 | $78,258 |
| 8 | $60,602 | $87,048 |
To apply for Medicaid in NC, you can:
- Apply online at the NC Medicaid website.
- Call the NC Medicaid Customer Service Center at 1-800-662-7030.
- Visit your local Department of Social Services office.
Special Needs Trusts and Medicaid Eligibility in North Carolina
A special needs trust (SNT) is a legal document that allows individuals with disabilities to access funds for healthcare, education, and other necessary expenses without disqualifying them from Medicaid benefits. In North Carolina, SNTs can be a valuable tool for ensuring that individuals with disabilities receive the care and support they need while preserving their Medicaid eligibility.
How Do Special Needs Trusts Work?
- An SNT is established by a parent, grandparent, or other legal guardian on behalf of an individual with a disability.
- The SNT is funded with the individual’s own money or assets.
- A trustee manages the SNT and uses the funds to pay for expenses related to the individual’s disability, such as medical care, therapy, and education.
Medicaid Eligibility and Special Needs Trusts in North Carolina
In North Carolina, SNTs are recognized as a way to protect an individual’s assets and still qualify for Medicaid benefits. However, there are specific rules and guidelines that must be followed in order for an SNT to be considered Medicaid-compliant.
To be Medicaid-compliant in North Carolina, an SNT must meet the following requirements:
- The SNT must be irrevocable, meaning that it cannot be changed or terminated once it is created.
- The individual with a disability must be the sole beneficiary of the SNT.
- The SNT can only be used to pay for expenses that are related to the individual’s disability.
- The SNT cannot be used to pay for basic living expenses, such as food, clothing, and shelter.
Benefits of Special Needs Trusts in North Carolina
There are several benefits to establishing an SNT in North Carolina, including:
- Preserving Medicaid eligibility: An SNT can help an individual with a disability to preserve their Medicaid eligibility, even if they have assets that would otherwise disqualify them.
- Providing financial security: An SNT can provide financial security for an individual with a disability by ensuring that they have access to funds to pay for necessary expenses.
- Protecting assets: An SNT can protect an individual’s assets from being used to pay for long-term care costs, such as nursing home care.
How to Establish a Special Needs Trust in North Carolina
To establish an SNT in North Carolina, you will need to work with an attorney who is experienced in estate planning and special needs law. The attorney can help you create a trust agreement that meets the requirements of North Carolina law and ensures that your loved one’s Medicaid eligibility is protected.
Disclaimer: This article is intended for general informational purposes only and does not constitute legal advice. It is recommended that you consult with a qualified attorney for specific advice regarding your situation.
Eligibility for Medicaid in North Carolina
In the state of North Carolina, Medicaid is a government-funded program that provides health coverage to residents who meet specific eligibility requirements. These requirements include factors such as age, income, and family status.
Applying for Medicaid in North Carolina
- Online: You can apply for Medicaid online through the North Carolina Department of Health and Human Services (DHHS) website.
- By Mail: You can also apply for Medicaid by mailing a completed application to the NC DHHS.
- In Person: You can also apply for Medicaid in person at your local DHHS office.
Regardless of the method you choose, you will need to provide certain information and documents to complete your application, such as:
- Your Social Security number
- Proof of income
- Proof of citizenship or lawful immigration status
- Information about your family members
Who is Eligible for Medicaid in North Carolina?
To be eligible for Medicaid in North Carolina, you must meet certain requirements, including:
- Age: You must be under 19 years old, 65 years or older, or blind or disabled.
- Income: Your income must be below a certain level. The income limit for Medicaid varies depending on your family size and situation.
- Family Status: You must be a citizen or lawful resident of the United States. You must also be a resident of North Carolina.
In addition to these general eligibility requirements, there are also specific eligibility requirements for certain groups of people, such as pregnant women, children, and people with disabilities. For more information on Medicaid eligibility requirements in North Carolina, please visit the NC DHHS website.
Medicaid Coverage in North Carolina
Medicaid provides a wide range of health coverage benefits to eligible individuals in North Carolina, including:
- Doctor visits
- Hospital care
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Long-term care
The specific benefits that you are eligible for will depend on your individual circumstances.
| Family Size | Income Limit |
|---|---|
| 1 | $2,313 |
| 2 | $3,092 |
| 3 | $3,871 |
| 4 | $4,650 |
| 5 | $5,429 |
| 6 | $6,208 |
| 7 | $6,987 |
| 8 | $7,766 |
Well, folks, that’s all we have time for today on who can get Medicaid in North Carolina. Thanks for hanging out with me. If you have any questions that I didn’t answer, be sure to check out the links in the description below. We’ll be back soon with more helpful information, so be sure to subscribe and hit that notification bell so you don’t miss a thing. Until next time, keep your head up, stay informed, and take care!