Benefits: Medicaid Eligibility

The different categories for Medicaid Assistance are:

1. Families eligible for Work First Family Assistance can be eligible for Medicaid Assistance if they are poor (meet income requirements and resources).

A family whose income is too high may still be able to get Medicaid Assistance if the family meets a deductible. The family must incur Medicaid bills in an amount determined by DSS. Once the bills are incurred, Medicaid coverage begins. The medical bills to meet the deductible must be incurred not necessarily paid

2. Medicaid Assistance is also available for persons who are over 65, or disabled or blind and in financial need. Persons in this category must not have income and resources higher than those imposed by Medicaid Assistance rules.

3. Children under age 21.

• The child’s family must also meet financial limitations.

4. Medicaid for pregnant women.

• Pregnancy must be medically verified and must also meet financial limitations.

5. Medicare recipients (Medicaid for Medicare qualified).

• Medicare recipient that meets financial limitations.

• This category of Medicaid assistance ONLY pays for Medicare premiums, deductibles and co-payments. The full range of Medicaid Assistance services is not available, to this category.

Medicaid can help you pay for hospital care, doctors’ care, nursing home care, prescription bills are also covered through selected health insurance coverage. If you are eligible for Medicaid Assistance your coverage may be up to 3 months before your application.
 

To apply for Medicaid Assistance, you should visit the county Department of Social Services or call them and ask them to mail you an application. If your application for Medicaid Assistance is denied, you can contact your nearest Legal Aid of North Carolina office or call 1-866-219-5262.

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To find other Legal Aid of North Carolina materials, including any materials mentioned in this document, go to lawhelpNC.org. If you need legal help please go to legalaidnc.org/.