North Carolina Medicaid

Eligibility Team
Researcher & Writer
December 12, 2017

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
  • Prescriptions

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.

Eligibility Team
Written by
Eligibility Team
We are a team of experts dedicated to finding the right government programs for you. Our mission is simple: help people quickly and easily understand which programs they might be eligible for—all in one place. Our team is dedicated to researching and providing you with the most relevant information. We compile only the most trusted information from government sources into one place so you can find the facts you need and skip what you don’t.
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