Medicaid Programs
IF you have a question about your benefits and coverage, please call your health plan at the number on your new Medicaid ID Card.
IF you want to change your health plan, please call the Enrollment Broker at 833-870-5500 or visit ncmedicaidplans.gov.
IF you want to change your Primary Care Provider only, call your health plan at the number on your new Medicaid ID card.
IF you have an issue with your health plan or provider which you have not been able to resolve after contacting the health plan or provider, call the North Carolina Medicaid Ombudsman at 877-201-3750 or visit ncmedicaidombudsman.org.
There are several different groups of individuals who qualify for Medicaid benefits. All have income limits and some have resource limits. Individuals who are eligible for full Medicaid benefits receive a Medicaid card each month. Medicaid may also be retroactive to cover medical bills from the 3 months prior to the month of application.
The income limit is lower than the income limit for children through the age of 18. There is a limit on resources.
Individuals who qualify for certain cash assistance programs automatically qualify for Medicaid without a separate application. If cash assistance ends, the Medicaid may be continued if the individual meets the eligibility criteria for another type of Medicaid. The programs which include automatic Medicaid are:
Please more information, please call 910-455-4145.
For more information, please call 910-219-4940, 910-219-4920 or 910-219-4904.
IF you want to change your health plan, please call the Enrollment Broker at 833-870-5500 or visit ncmedicaidplans.gov.
IF you want to change your Primary Care Provider only, call your health plan at the number on your new Medicaid ID card.
IF you have an issue with your health plan or provider which you have not been able to resolve after contacting the health plan or provider, call the North Carolina Medicaid Ombudsman at 877-201-3750 or visit ncmedicaidombudsman.org.
There are several different groups of individuals who qualify for Medicaid benefits. All have income limits and some have resource limits. Individuals who are eligible for full Medicaid benefits receive a Medicaid card each month. Medicaid may also be retroactive to cover medical bills from the 3 months prior to the month of application.
Medicaid for Aged (65 & Older), Blind and Disabled Persons
The income limit is equal to 100% of the poverty level. There is a limit on resources.Medicaid for Long Term Care
Medicaid pays for medically necessary nursing home care for patients in skilled or intermediate care nursing homes or in intermediate care facilities for the mentally retarded. The patient's income must be less than the cost of care in the facility at the Medicaid rate, and there is a limit on resources. If the patient or his representative gives away assets or sells them for less than market value, he may be ineligible for payment of the cost of care. The sanction period is based upon the value of the assets transferred away. For more information on the Long-Term Care program, call 910-219-4800, 910-219-4929 or 910-219-4810.Medicaid for Pregnant Women
The family income limit is equal to 185% of the poverty level. There is no limit on resources. If a pregnant woman is covered by Medicaid, her newborn child is automatically eligible for Medicaid up to age 1. This benefit is available even if the pregnant woman has no other children.Medicaid for Children from Age 1 - Age 18
The family income limit varies depending on the age of the child. There is no resource limit.
Medicaid for Caretakers & Children Age 19 & 20
The income limit is lower than the income limit for children through the age of 18. There is a limit on resources.Medicaid for Medically Needy
Coverage for parents and children whose incomes are higher than those allowed in other coverage groups. Families must meet a deductible based on the amount by which their income exceeds the income limit. There is a limit on resourcesMedicaid "Be Smart" Family Planning Program
Be Smart is a Medicaid "waiver" program that is available to North Carolina residents who do not qualify for other Medicaid benefits. The Medicaid "Be Smart" Family Planning Program is limited to services related to family planning.Automatic Eligibility for Medicaid
Individuals who qualify for certain cash assistance programs automatically qualify for Medicaid without a separate application. If cash assistance ends, the Medicaid may be continued if the individual meets the eligibility criteria for another type of Medicaid. The programs which include automatic Medicaid are:
- 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, blind and disabled individuals
Special Assistance
This is a cash assistance program which pays for care for individuals who are placed in Rest Homes or are receiving In-Home Assistance to keep them from being placed in a facility. There is an income and resource limit for this program and, if found eligible, the person automatically qualifies for Medicaid assistance. For more information, please call 910-219-4845 or 910-219-4810.Medicare-Aid
Individuals who have Medicare coverage may be eligible to have their Medicare premiums paid by Medicaid if their income is between 100% and 135% of the poverty level. There is a limit on resources.NC Health Choice for Children
Children who are under age 19 may qualify for free or low cost health insurance if they are uninsured and if the family income is higher than the Medicaid limits but less than 200% of the poverty level. There is no limit on resources. The coverage is similar to that of Medicaid. Eligible children receive a card which is valid for one year (unless they move out of state or become insured through another source).Please more information, please call 910-455-4145.
Medicaid Transportation
This program provides transportation for Medicaid recipients to and from doctor visits. Utilizes OUTS van and taxis.For more information, please call 910-219-4940, 910-219-4920 or 910-219-4904.