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|North Carolina Enrollment Banker Virtual Education Series||Medicaid Managed Care Event|
North Carolina Enrollment Banker Virtual Education Series
Medicaid Managed Care Event
Title XIX of the Social Security Act requires states to establish Medicaid programs to provide medical assistance to low income individuals and families. In North Carolina, the Medicaid program is administered by the Human Resources, Division of Medical Assistance (DMA). Eligibility for Medicaid is determined by the Hertford County Department of Social Services (DSS)and the Social Security Administration (SSA) for Supplemental Security Income (SSI) recipients. It is jointly financed with federal, state, and county funds.
In order to receive Medicaid, individuals must meet the requirements under a specific categorical group covered by North Carolina. In addition, financial and non-financial criteria for each group must be met. The following is a list of Adult Medicaid programs administered by DSS: Medicaid assistance for the Aged; Medicaid assistance for the disabled; Medicare Beneficiary Programs; assistance for Institutionalized Care. The Adult Medicaid Manual may be reviewed on line at http://info.dhhs.state.nc.us/
Family and Children’s Medicaid:
Family and Children’s Medicaid provides medical coverage for qualifying residents of North Carolina.
There are certain income requirements and in some programs resource limits by which eligibility is determined. The Family and Children’s Medicaid Manual explains the rights and responsibilities of persons who apply for assistance. The Manual may be reviewed online at http://info.dhhs.state.nc.us/
North Carolina Health Choice:
NC Health Choice for Children (NCHC) is only for children ages 6 through 18 and is a health insurance coverage and the carrier is HP Enterprises. Although administered by the Division of Medical Assistance, NCHC is not a Medicaid entitlement program.
To be eligible for NC Health Choice a child cannot be eligible for full Medicaid benefits or have comprehensive private health insurance.
Medicaid Managed Care FAQ’s:
Click on the link below to access frequently asked questions about Medicaid Managed Care.