How to File for Medicaid in Nc

You can apply for Medicaid coverage in North Carolina easily. In order to get started, you can either submit an application online or by phone. You’ll have to provide information like your income, assets, and household size. If you qualify, you’ll get a Medicaid card in the mail. You can use this card to get free or low-cost health care services. There are no asset limits for people who are 65 and older, blind, or disabled. There are income limits for all other adults. The income limit for a single person is $1,482 per month. The income limit for a married couple is $2,964 per month.

Eligibility Requirements for Medicaid in North Carolina

To qualify for Medicaid in North Carolina, you must meet specific eligibility requirements. These requirements include:

  • Income: Your income must be at or below a certain level. The income limit varies depending on your household size and composition.
  • Assets: You must have limited assets. The asset limit varies depending on your household size and composition.
  • Citizenship or legal residency: You must be a U.S. citizen or a legal resident of North Carolina.
  • Age: You must be under 19 years old, 65 years old or older, pregnant, or disabled.
  • Disability: If you are disabled, you must meet certain medical criteria.

In addition to these general requirements, there are specific eligibility requirements for certain groups of people. For example, children under the age of 19 may be eligible for Medicaid if they meet certain income and asset limits. Pregnant women may also be eligible for Medicaid if they meet certain income and asset limits.

If you are unsure whether you are eligible for Medicaid, you can apply online or contact your local Department of Social Services.

Income Limits for Medicaid in North Carolina
Household Size Income Limit
1 $1,683
2 $2,260
3 $2,838
4 $3,415
5 $3,993
6 $4,570
7 $5,148
8 $5,725

Application Process

Filing for Medicaid in North Carolina involves a straightforward process. To initiate the application, you can choose one of these three options:

  • Online Application: Visit the North Carolina Department of Health and Human Services (NCDHHS) website and navigate to the Medicaid application page. Fill out the online form with accurate and complete information.
  • Paper Application: You can download the Medicaid application form from the NCDHHS website, print it, and fill it out manually. Submit the completed form to the local Department of Social Services (DSS) office in your county.
  • In-Person Application: Visit your local DSS office and request a Medicaid application form. Fill out the form in the presence of a DSS representative who can guide you through the process and answer any questions you may have.

Once you have submitted your application, the DSS will review it to determine your eligibility for Medicaid. The review process typically takes 30 to 45 days, but it can vary depending on the complexity of your application and the workload at the DSS office.

Necessary Documentation

To support your Medicaid application, you will need to provide various documents to verify your identity, income, and assets. These documents may include:

  • Proof of Identity: Government-issued photo ID, such as a driver’s license, state ID card, or passport.
  • Proof of Residency: Recent utility bill, lease agreement, or property tax statement showing your current address.
  • Proof of Income: Pay stubs, W-2 forms, Social Security award letters, pension statements, or self-employment income documentation.
  • Proof of Assets: Bank statements, investment account statements, vehicle registration, and property deeds.
  • Social Security Number: Provide your Social Security number for each member of your household applying for Medicaid.
  • Citizenship or Immigration Status: Proof of U.S. citizenship or lawful immigration status, such as a birth certificate, naturalization certificate, or green card.
  • Pregnancy Verification: If you are pregnant, provide documentation of your pregnancy from a healthcare provider.
Income and Asset Limits for Medicaid Eligibility in North Carolina
Income Limit Asset Limit
Individuals 138% of the Federal Poverty Level $2,000
Couples 138% of the Federal Poverty Level $3,000
Families with Children Varies based on family size $3,000

Note: Income and asset limits are subject to change. Please visit the NCDHHS website for the most up-to-date information.

Medicaid Coverage and Services Available in North Carolina

Medicaid is a joint federal and state program that provides health coverage to individuals and families with low incomes and resources. In North Carolina, Medicaid is known as NC Medicaid. NC Medicaid covers a wide range of health care services, including:

  • Doctor visits
  • Hospital care
  • Dental care
  • Vision care
  • Prescription drugs
  • Mental health and substance use treatment
  • Long-term care
  • Transportation to medical appointments

NC Medicaid also offers a variety of optional services, such as:

  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Home health care
  • Personal care services

To be eligible for NC Medicaid, you must meet certain income and resource requirements. The income limits vary depending on the type of Medicaid coverage you are applying for. The resource limits are the same for all types of Medicaid coverage. You can find more information about the eligibility requirements on the NC Medicaid website.

Type of Medicaid Coverage Income Limits
Regular Medicaid 138% of the federal poverty level
Medicaid for Children and Pregnant Women (NC Health Choice) 200% of the federal poverty level
Medicaid for People with Disabilities No income limit
Medicaid for Long-Term Care No income limit

Appeals Process for Medicaid Denial in North Carolina

If your Medicaid application is denied, you have the right to appeal the decision. The appeals process can be complex, but there are resources available to help you. Here is an overview of the steps involved in the Medicaid appeals process in North Carolina:

  1. Request a Fair Hearing:
    • Within 10 days of receiving your denial letter, you must request a fair hearing by submitting a written request to the Division of Medical Assistance (DMA).
    • You can also request a fair hearing by calling the DMA at (877) 777-4527.
  2. Prepare for Your Hearing:
    • Gather all relevant documents and evidence supporting your claim for Medicaid.
    • You may also want to seek legal advice or representation.
  3. Attend Your Hearing:
    • The hearing will be conducted by an impartial hearing officer.
    • You will have the opportunity to present your case and evidence.
    • The hearing officer will make a decision based on the evidence presented.
  4. Appeal the Hearing Decision:
    • If you are dissatisfied with the hearing officer’s decision, you can appeal to the Office of Administrative Hearings (OAH).
    • The OAH will review the record of the hearing and issue a final decision.

The appeals process can take several months, so it is important to start the process as soon as possible. If you need help with the appeals process, you can contact the North Carolina Legal Aid (NC LA) at (866) 219-5262.

Additional Resources

Hey, thanks for reading this quick guide on applying for Medicaid in North Carolina! I hope it’s been helpful, but if you still have questions, don’t hesitate to reach out. You can find more information on the official Medicaid website, or you can always give their office a call. Good luck with your application and remember, there are people out there who want to help you get the care you need. Stay healthy, and I hope to see you again soon!