Medicaid is a program that provides health coverage to some low-income North Carolina residents. Medicaid covers families with children and pregnant women, the elderly, people with disabilities, and medically needy individuals if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid. Non-citizens who do not have immigration documents cannot enroll in Medicaid.
· For certain categories of people, eligibility for Medicaid is based on the amount of your household income.
In North Carolina you may be eligible for Medicaid if you are an infant, a child, pregnant, a parent of a child, or medically needy and your family income meets the Medicaid income standards.
Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account, so you should contact the North Carolina Division of Medical Assistance at the Department of Health and Human Services for more information.
· Parents who receive benefits under TANF (also known as Work First) should know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 12-month transitional period.
In addition, your children may qualify for transitional Medicaid coverage for 12 months. Or, you may qualify for Medicaid yourself if your family’s income meets the Medicaid income standards.
· Very poor elderly or disabled people who get Supplemental Security Income (SSI) benefits can also qualify for Medicaid.
Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage at least for a limited time.
· People who have high medical expenses may also qualify for Medicaid. You may qualify as medically needy if you are a child, parent of a dependent child, pregnant, elderly, or disabled and have high medical expenses that, when subtracted from your income, would make you eligible for Medicaid coverage. For example, people who have to pay a lot for prescription drugs, nursing home care, or other long term care services sometimes qualify as medically needy if they do not have health insurance that covers these services.
· Retired or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid insurance coverage, there may be other ways Medicaid can help you.
If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance. This is called the Qualified Medicare Beneficiary (QMB) program.
If your household income is below 120% of the poverty level, Medicaid will pay for your monthly Medicare premiums only. This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.
Contact your County Office of Public Assistance for more information about other eligibility requirements.
· There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact the Division of Medical Assistance at the Department of Health and Human Services.
To obtain the locations and telephone numbers of sites near you call the Division of Medical Assistance of North Carolina at the Department of Health and Human Services.
· To apply for Medicaid, call your local Division of Social Services (DSS). You can also ask to have an application mailed to you. More information is available at http://www.dhhs.state.nc.us/dss/contact/index.htm or by calling (800) 662-7030 or (919)733-3055.