North Carolina Medicaid Application

Between 2013 and 2014, Medicaid coverage of the populace in North Carolina remained unchanged at 18 percent. This is largely due to the state’s refusal to expand the Medicaid program to pay more individuals who get lower incomes. Under the terms of the Affordable Care Act, states have to expand Medicaid to pay these very low income earning individuals. Since, the Supreme Court has raised the requirement and because of this, North Carolina has over 500,000 residents left in the coverage gap. The policy gap represents individuals in the country who make too much income to apply for Medicaid, but too little to afford private health insurance.

Governor Pat McCrory believed Medicaid growth for people from the country, but only with a work requirement attached. Because of forgoing Medicaid growth, the country stands to lose out on as much as $39.6 billion in federal funding. Regardless of the governor’s resistance, Medicaid growth is preferred by residents of the nation.

What’s Covered Under Medicaid in North Carolina

• Freestanding birthing center services are supplied under Medicaid to pregnant women to give birth and get care following birth of their baby.
• Inpatient and outpatient hospital services are provided to individuals who want short and long-term maintenance.
• Rehabilitation services are intended to help residents who need help recovering from substance abuse issues.
• Prescription medications are provided to qualified participants under the program.
• Occupational and physical therapy services are provided to those who qualify for protection.
• Ambulance and non-emergency transport services are covered to allow participants to reach hospitals and clinics to get care.
• Personal care services are provided to individuals that are not able to carry out routine everyday tasks for themselves.
• Hospice care is provided to help out with treatment decisions regarding end of life care.
• Inpatient psychiatric services are provided to covered participants that are under the age of 21.

Who’s Covered Under Medicaid

• Pregnant women whose family income doesn’t exceed 196 percentage of the federal poverty level can get maternity services.
• Kids whose household income doesn’t exceed 211 percentage of the poverty level may qualify for CHIP or Medicaid.
• Some 19 and 20 year olds are offered coverage under Medicaid if their family income doesn’t exceed 46 percent of the federal poverty level.
• Parents with dependent children are eligible if their family income is below 45 percent of the federal poverty level.
• Be Smart, the Medicaid family planning program, accepts residents whose family income doesn’t exceed 195 percent of the federal poverty level.

To be able to apply for Medicaid coverage in North Carolina, residents may use four distinct approaches: online at ePass, by phone, with a paper program, or in person at a Social Services office. Online applications can also be taken using healthcare.gov or by phoning 1-800-318-2596.

After the Medicaid Application

Following submission of the program, residents will typically get a response within a 45 day time period. For applicants who have been turned down, there is the right to submit a petition for an appeal.

A Recipient Hearing Request form will be included with the refusal notification so that residents have the ability to appeal unfair or erroneous Medicaid decisions. The addresses for the two departments are listed on the refusal notice. Hearings are held in Raleigh, North Carolina unless this has turned out to be a hardship for the applicant. Decisions on hearings are supplied within 20 days of the hearing date.

A reduction of this hearing nevertheless provides applicants the ability to appeal that decision.

Medicaid enrollment is offered all throughout the year, so residents don’t have to await an open enrollment period.