What is Medicaid?
Medicaid is a means-tested program, which means that eligibility is
based on a person’s income level and assets. It is run through a
cooperative effort of the federal, state, and local governments. The
state usually administers the program. The Medicaid program is run by
your state and the counties within your state.
Medicaid is not a
charity. It is a right to which you are entitled to by law—like the
right of a child to attend public school. Medicaid is paid for by taxes,
and everyone pays taxes.
Medicaid differs from state-to-state in
terms of who can get Medicaid, what services get paid for, and how
services get paid for. In North Carolina, you may be eligible for
Medicaid if:
- You are 18 or under;
- Age 65 or older;
- Blind;
- Disabled (The Social Security office determines if you are disabled);
- The caretaker/relative of (living with and caring for) a child under age 19 who receives Medicaid;
- Pregnant
You are automatically eligible for Medicaid if you are enrolled in one of the following programs:
- Work First Family Assistance for families with children;
- Supplemental Security Income (SSI) for elderly, blind and disabled individuals;
- State/County Special Assistance (SA) assistance for payment of rest home expenses for elderly.
For more detailed information on North Carolina Medicaid Eligibility,
go to the North Carolina Division of Medical Assistance webpage: http://www.dhhs.state.nc.us/dma. There is also a
useful booklet created by the NC Department of Health and Human Services
all about Medicaid in North Carolina. Please click here for a copy.
**REMEMBER: This information is
sometimes confusing and overwhelming. Don’t be afraid to ask for help.
If you live in North Carolina, please call the CARE-LINE
(1-800-662-7030). You have a right to this information, and the
CARE-LINE is staffed with persons who can help you understand it and
provide you with information and referrals.
There is a mail-in Medicaid application that you can fill out and mail or drop off at your county's department of social services. Click HERE for the application. Click HERE for a directory of North Carolina DSS Offices.
Medicaid for End Stage Renal Disease Patients
If you qualify for the Medicare ESRD program and Medicaid, Medicaid can pay for your Part B deductible and for the 20% of your medical costs that Medicare does not pay for.
Even if you do not qualify for the Medicare ESRD program, you may still be eligible for Medicaid to help pay for dialysis treatments and medications.
In North Carolina, Medicaid services can be given to someone if they are on dialysis, are a newly transplanted individual (coverage during the first year of transplant), and if they meet certain criteria (for example, having nephrotic syndrome). You do not have to have reached end stage renal disease to be eligible for assistance. You can call your local Department of Social Services or the CARE-LINE (1-800-662-7030) for more information. Your dialysis social worker can also help you figure out if you may be elgible for Medicaid.
Medicaid for Children (Health Check/Health Choice)
North Carolina offers comprehensive health care coverage for children up to age 21 if their family income meets certain requirements. Health Check (the Medicaid Insurance Program) and Health Choice are two similar health insurance programs. Your family’s income, the number of people in your family and the age of the children determine if you or your children qualify. Medicaid services for children include coverage of preventive visits, sick visits, dental care, prescriptions, hearing exams, and hospital vsiits.
There is a combined application for these programs that you can fill out and mail or drop off at your county's department of social services. Click HERE for the application. Click HERE for a directory of North Carolina DSS Offices.
Quicklinks:
National
Centers for Medicare & Medicaid Services
North Carolina
NC Division
of Medical Assistance
NC Division
of Social Services
