North Carolina MedicaidUpdated December 12, 2017 Medicaid
Having medical insurance is a top priority for anyone. Medicaid can help families and individuals get the coverage that you need. There is a quick and easy process that will help determine if you are eligible for the program.
Medicaid Eligibility in North Carolina
When it comes time for you to apply for Medicaid you will want to figure out, first if you are eligible. There is a varying set of criteria that each state goes by to assess every person and deem them eligible to receive Medicaid. The criteria for North Carolina is as follows:
- The applicant's age
- The health needs of the applicant
- The income and resources of the applicant
You can find out more and see if you are eligible for benefits by checking the criteria.
After it has been decided that you are in fact eligible to receive Medicaid in North Carolina you will then need to apply. There are several different methods that can be used to do this, either in person, through the mail or on the telephone. No matter what way you go the process will end up being the same and you will need to have all vital information available in order to complete the form.
What Does Medicaid Cover in North Carolina
North Carolina Medicaid recipients will receive a copy of the program when they enroll in the program. The main things covered in the Medicaid program are as follows:
- Hospital Bills
- Mental Health Care
- Doctor Bills
- Vision Care
- Most medical services that are needed for minors under 21
- In-home care
- Dental care
- Medicare premiums
- Personal care services. Medical equipment as well as other types of home and health services
- Nursing home care
The income guidelines for those seeking Medicaid in North Carolina vary from one group of people to the next. The Aged, blind and disabled have a set amount based on family size, while a pregnant woman will have a different amount of their income based on family size. You can view all of the criteria on the North Carolina Medicaid webpage.
The cost of Medicaid will vary depending on the type of service that you are using. The price can run anywhere from $1 to $100 however, most are usually under $30. Some of the things that you will be expected to make a co-payment on are:
- Services provided to CAP participants
- Services that are covered by both NC Medicaid and Medicare
- Brand name and generic prescriptions
- Going to see an ophthalmologist, dentist, podiatrist, and doctors
- Chiropractic care
- In-home care for adults and children
- Services in a psychiatric hospital that are run by the state
- Non-Hospital dialysis facilities
- Non-emergency visits to the emergency room
Anyone with a low income in North Carolina can be assured that they will be able to receive the medications that they need in order to maintain a healthy lifestyle. Three ways that the drugs are provided are through stockholder collaborations, drug rebates and use of the Preferred Drug List.
Which Plans Are Good in North Carolina?
CHIP or Children’s Health Insurance Program is a program designed for families with children that are not eligible to receive Medicaid but still need medical insurance for their children. While they may seem as if they are part of the same program, the rules and regulations that govern them are different.
The eligibility requirements for CHIP are:
- Applicant must be 19 or younger
- Must be a citizen of the U.S or legal resident
- Applicant must meet the income guidelines set for the program
- Applicant must not be on any type of private health insurance or Medicaid
The services offered to those on CHIP are pretty much the same as those with Medicaid. From Doctors visits to prescription drugs and emergency services and transportation. CHIP may also cover some expenses that Medicaid does not cover. Applying for CHIP can be done in the same way as Medicaid, by phone, mail or in person at your local social services department. Be sure that when applying that you give all information that is required, as giving any false information can result in criminal charges being brought against you. For more info on the CHIP benefits, you can download the guide.