A Consumer's Guide to North Carolina Medicaid Health Insurance Programs for Families & Children

North Carolina's Medicaid Program, which is supported by federal, state and local funding, covers more than a million North Carolina residents. In addition to providing health care coverage to families and children, the program covers individuals who are elderly or disabled, individuals requiring long-term care and some Medicare recipients. North Carolina Medicaid helps low-income people who meet eligibility requirements with their health care needs.

Eligibility

• To qualify for Medicaid you must be a U.S. citizen, permanent resident or legal alien. You must also have a social security number and provide proof that you are a North Carolina resident. If you are receiving Supplemental Security Income, Work First Family Assistance or Adult Care Home Assistance, you are automatically eligible. Families may also qualify based on their income, family size and the age of their children. For example, a family of four with children less than six years old and a monthly income of $3,675 is eligible for benefits. (See Resources for specific income limits.)

Coverage

• Medicaid covers a wide variety of a qualifying family's medical expenses, including doctor visits, hospital expenses, medication, vision care, dental care and mental health care. The program provides wide coverage for children under 21 years old, including most medically necessary services. It also covers nursing home care, personal care services, the cost of medical equipment and home health services, including those provided under the Community Alternatives Program.

Programs for Families

• In addition to standard medical coverage, Medicaid provides services through several specialized programs. The Be Smart Program offers free family planning and birth control to residents who are not otherwise eligible for Medicaid. The Community Alternatives Program for Children offers case management and in-home care, as well as services to supplement Medicaid support, to children with extraordinary medical needs. The Baby Love program helps pregnant women and new mothers with care, counseling and support.

How to Apply

• You can apply for Medicaid in person or by mailing your application to your county's Department of Social Services. (See Resources) You must provide a number of documents to support your application, including proof of citizenship and social security numbers for each applicant, proof of income, copies of insurance policies and a list of all the vehicles and real property that you own. You may not fax the application or send it by Internet.

Additional Information

• You can access comprehensive information on North Carolina Medicaid at the Division of Medical Assistance website. (See Resources) For personal assistance with your Medicaid questions, call the Care-Line Information and Referral Service, which provides services in English and Spanish and is available between 8:00 a.m. and 5:00 p.m., Monday through Friday.