If you meet eligibility requirements, Medicaid will pay for some portion of your cost of care in a long term skilled or intermediate care facility as well as medical expenses.
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Beginning December 1, more people in North Carolina will be eligible for health care coverage through Medicaid. Current recipients will still be eligible for health care coverage under the new Medicaid expansion. You are eligible for Medicaid if you meet the criteria below:
$1,676 per month or less
$2,267 per month or less
$2,859 per month or less
$3,450 per month or less
add $591 per month
add $7,094 annually
Prepare the following documents below for each person applying to help complete your application:
North Carolina uses external resources to verify the information you provide. If more information is needed, you will receive a letter in the mail from the Department of Social Services requesting additional documentation, including:
North Carolina uses external resources to verify the information you provide. If more information is needed, you will receive a letter in the mail from the Department of Social Services requesting additional documentation.
If you are pregnant and/or have a child/children age(s) 5 and under, you may be eligible for Women Infants and Children (WIC) services by calling 910-798-3500, select option 5 when prompted.
Applications may be mailed upon request. Applications and supporting documents can be emailed to firstname.lastname@example.org as needed.
You do not have to pay any monthly premiums.
Medicaid pays the cost for most health care services.
The highest copay is $4 and that is only required on some services.
It may take up to 45 days after you apply. Incomplete applications may take longer.
You can help the process go faster by:
Some non-U.S. citizens can get health coverage through Medicaid. To be eligible you must be:
Non-citizens without documents who do not qualify for full health coverage under Medicaid may be able to get temporary coverage for emergency conditions that need to be treated in an emergency room.
Medicaid benefits and eligibility vary according to a person’s circumstances and what Health Plan you are linked to.
If you are not linked to a Health Plan you should call the Enrollment Broker to see what your options are based on the Health Plan you choose. https://ncmedicaidplans.gov/enroll/online/find/find-provider?lang=en
Call the Primary Health Plan that is on your Medicaid card. If you are not enrolled with a plan, call Social Services at 910-798-3500 option 4.
As defined by Social Security, it is a physical or mental impairment which prevents an individual from engaging in any substantial, gainful activity, and which has lasted or is expected to last for at least 12 months, or is expected to result in death. To apply for disability benefits, you must apply through the Social Security Administration offices, 800-772-1213 or 800-325-0778 (TTY).
Medicaid pays the medical provider directly. No payment is made to the recipient. Persons residing in Adult Care Homes (often called rest homes) may be eligible for a check under the Special Assistance Program to help pay for their monthly cost of care in the home. Clients who qualify for Work First Family Assistance “WFFA” get a check.
If you receive CAP or are in a long term care facility, estate recovery may apply to you. This means at the time of your death the government may make a claim against your estate to recover the money paid to medical providers on your behalf.