What are the requirements for Medicaid? The Medicaid eligibility requirements in North Carolina are not the same as in other states. Benefits eligibility has not fluctuated much to accommodate more applicants, as the state has not accepted the Medicaid expansion. Nonetheless, if you are interested in enrolling, the first step is to review how to qualify for Medicaid.
When assessing who is eligible for Medicaid, age, health, income, and resources are taken into account.
How to Find Out Who Meets the Requirements for Medicaid
What are the requirements for Medicaid? You can get basic information on NC Medicaid benefits eligibility through the following:
- By phone: If you have a personal situation that is not discussed via the general requirements for Medicaid listed online, consider calling the state Medicaid helpline for more information.
- In person: If you cannot reach a Medicaid representative by phone, go into your nearest Medicaid office. There, you can speak with a trained professional regarding your Medicaid benefits eligibility status.
Since Medicaid applications are time-consuming, it is to your benefit to ensure you qualify for Medicaid benefits before engaging in the process. If you do not qualify for Medicaid and decide to file your paperwork regardless, the outcome will most likely remain the same. Save valuable time by confirming your eligibility status beforehand.
What Are the Financial Medicaid Eligibility Requirements in North Carolina?
Medicaid in NC can be granted to recipients who are age 65 or older and children/infants 21 and younger. Applicants that may require long-term care, are disabled or blind and are living on low incomes are likely eligible for Medicaid. Keep in mind that proofs of citizenship and NC residency are both essential to be eligible for Medicaid.
Learn more about Medicaid requirements by downloading our comprehensive guide.
When it comes to the financial eligibility for Medicaid benefits for North Carolina’s residents, keep the following two details in mind:
- Resources must not exceed $2,000 for individual beneficiaries. Couples applying for Medicaid coverage in NC must not exceed the $3,000 resource limit.
- Monthly income must not exceed $867 for individual beneficiaries. What are the Medicaid application guidelines regarding the incomes of couples in NC? The number must not exceed the $1,167 monthly income limit.
What are the Medicaid application guidelines in regard to assets? To be eligible for Medicaid, stocks, bonds, retirement accounts, bank accounts, and real estate must be counted as resources, so long as real estate is not the recipient’s actual home. Clothing, furnishings and primary property are not considered resources.
Medicaid benefits eligibility in NC states that a deductible must be paid by the beneficiary if monthly income limits are exceeded. The deductible is based on Medically Needy income guidelines – $242 for single recipients and $317 for couples.
But exactly what are the income requirements for Medicaid in NC? The fact that the medical assistance program is designed for low-income families and individuals means that the Medicaid income requirements are firm. Total income will be calculated by a caseworker in North Carolina, who will then decide if you have met the income and resource requirements.
What are the income requirements for Medicaid broken down by group? Find the numbers below:
- Medicaid for the aged, blind and disabled – Income requirements to be eligible for Medicaid are $990 for households with one person and are $1,335 for households with two people.
- Medicaid for families with dependent children – Medicaid income requirements are $434 for households with one person, $569 for households with two people, $667 for households with three people and $744 for households with four people.
- Medicaid for infants and children – North Carolina Medicaid eligibility requirements for income are $1,317 to $2,079 for households with one person, $1,776 to $2,804 for households with two people, $2,235 to $3,528 for households with three people, $2,694 to $4,253 for households with four people and $3,153 to $4,977 for households with five people.
- Medicaid for pregnant women – Income Medicaid eligibility requirements are $2,617 for households with two people, $3,293 for households with three people and $3,969 for households with four people.
Learn About Medicaid Programs in North Carolina
Now that you understand the income requirements for Medicaid in North Carolina, the programs can be covered a little more in-depth. There are four main programs run by the federal government of North Carolina, and once enrolled in each program, the cost of services and assistance will be covered for the recipient.
Medicaid qualifications for the following programs are based on income and general non-financial criteria:
- Medicaid for the aged, blind and disabled – Three kinds of coverage are included when someone is able to qualify for Medicaid in this category. They are the Categorically Needy Program (CN), Medically Needy Program with no spend-down (MN) and Medically Needy with spend-down.
- Family Medicaid – Tests, hospital visits, prescriptions, and medical care are included in this program. Adults can enroll children once they learn how to qualify for Medicaid in NC. A co-payment may be required in some cases.
- North Carolina Health Choice – Working families that earn more than the income requirements for Medicaid are served by this program. Annual premiums range from $50 to $100, and the health insurance covers patients ages 6 to 19.
- Carolina Access – Coordinated health care is available for beneficiaries who learn how to qualify for Medicaid in NC under the Carolina Access program. Money is saved with this option because just one primary care physician manages the recipient’s health care.