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Friday, February 26, 2021

What Are the Eligibility Requirements for Medicaid in North Carolina?

Many people may not think about Medicaid benefits until they actually need them. Medicaid provides critical benefits to individuals in need throughout the U.S. A program administered at the state level, Medicaid is health insurance provided to people who have demonstrated the inability to afford medical care payments in full or in part. Instead of paying benefits directly to an individual, Medicaid is also like health insurance in the way that it makes payments directly to health care providers. In some states, you may have to make a small co-payment for certain medical services.

What Are the Eligibility Requirements for Medicaid in North Carolina?

Medicaid eligibility requirements are very specific. Medicaid benefits will only be available to those low-income families and individuals who fall within an eligibility group recognized by state and federal law. In North Carolina, your local Department of Social Services (DSS) caseworker will be tasked with determining whether you are eligible for Medicaid. Your eligibility will hinge on your age and health needs as well as your income level and available resources.

The following people may be eligible to receive Medicaid benefits:

  • Those aged 65 or older
  • Blind or disabled individuals
  • Infants
  • Children under the age of 21
  • Pregnant women
  • Low-income individuals and families
  • Those needing long-term care
  • Those receiving Medicare

To be eligible for Medicaid in North Carolina, you must live in the state and provide proof of your residency. You must also have a Social Security number or be in the process of applying for one. Furthermore, you must be a U.S. citizen or be able to provide proof that you have an eligible immigration status. The exception to this being if you are applying just for emergency services in which case you will not be required to provide documentation regarding your immigration status.

Certain individuals will be automatically eligible for Medicaid including those currently receiving Supplemental Security Income (SSI) and State or County Special Assistance for the Aged or Disabled. Others will need to prove that they meet the income and resource eligibility requirements. This is because Medicaid is intended for individuals with low income and limited access to resources. The income and resource limit will vary depending on the Medicaid program that you need to fit your age and health care needs. Your local DSS caseworker is tasked with determining your income level and available resources.

Elder Law Attorney

Medicaid benefits can provide critical support to those in need of help covering the sometimes extreme costs of health care. This is particularly true of those in need of long-term care. It is estimated that more than half of the population will need long-term care at some point in their lives. With the costs of long-term care reaching astronomical levels, you should be prepared to seek benefits such as Medicaid. The dedicated elder law team at Monk Law can help you put these plans in place. Contact Monk Law today.


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