Difference between revisions of "Medicaid/NC"

Latest revision as of 12:00, 6 January 2017

About

Medicaid in North Carolina is supervised by the North Carolina Department of Health and Human Services Division of Medical Assistance (NC DHHS DMA); the NC DHHS DMA home page appears to also be the focal point for information about both Medicaid in NC and another program called NC Health Choice for Children (NCHC, NC's version of SCHIP) which "provides funding to extend health care coverage to roughly 115,000 children each month whose family income exceeds Medicaid financial eligibility criteria".

Eligibility - EIS

There does not appear to be any human-readable manual or official rules for determining eligibility for NC Medicaid; rather, eligibility is determined through entering the potential client's information into a mainframe-based computer program called the Eligibility Information System (EIS).

There is a single-page "desk reference" covering basic eligibility requirements, but it does not handle all cases (e.g. maximum qualifying income for more than 2 children).

Local Contacts

Medicaid applications and hearings are administered by each county's Department of Social Services. The directory sometimes has outdated links.

Durham County: Durham County Department of Social Services
- ~~Medicaid~~ (durhamcountync.gov seems to be down as of 2015-07-14)

Stories

Josh: a tale of first being denied for having filled out the wrong form, and then being denied for not having turned in documentation even though they never told us they were missing it and wouldn't respond to phone calls. As of this writing, we're being told we have to apply for a third time, and we still don't know what documentation is missing. --Woozle 17:05, 7 August 2008 (EDT)

Notes

Apparently children always go through NC Health Choice for Children, or perhaps only if the parents' income is too high to qualify for regular Medicaid. In any case, the questions on the Adult Medicaid form simply don't make sense when applying on behalf of a disabled child. --Woozle 07:32, 11 June 2008 (EDT)

Confirmed: Josh ultimately got Medicaid by applying using a Health Choice/Health Check application. --Woozle 16:07, 29 December 2009 (UTC)

Links

Official

Information for Medicaid Consumers: links to related pages and documents
Medicaid Eligibility Summary: different ways to be eligible; includes NCHC eligibility
How to Apply for North Carolina Medicaid and/or Health Choice for Children
- application forms
Adult Medicaid Manual
Family and Children's Medicaid Manual (does not apply for Aged, Blind and Disabled; those are under Adult, as explained here)
Adult Medicaid Manual MA-200: DEFINITIONS: extensive list of acronyms and program names

News

North Carolina Medicaid
- 2017-01-04 New governor vows to expand Medicaid unilaterally; Republican lawmakers fighting him
2016-12-07 NC health plan to cover sex changes, if medically necessary, in 2017 (archive)

@@ Line 1: / Line 1: @@
-==Overview==
+<hide>
-[[category:US.NC]][[Medicaid]] in [[North Carolina]] is administered by the [[NC DHHS DMA]] (NC Department of Health and Human Services Division of Medical Assistance); the [http://www.dhhs.state.nc.us/dma/ NC DHHS DMA home page] appears to also be the focal point for information about both Medicaid in NC and another program called [[NC Health Choice for Children]] (NCHC, NC's version of [[SCHIP]]) which "provides funding to extend health care coverage to roughly 115,000 children each month whose family income exceeds Medicaid financial eligibility criteria".{{seedling}}
+[[page type::article]]
+[[thing type::government program]]
+[[government type::federal]]
+[[area::US/NC]]
+[[category:US/NC/gov]]
+</hide>
+==About==
+'''[[Medicaid]] in [[North Carolina]]''' is supervised by the [[North Carolina Department of Health and Human Services Division of Medical Assistance]] ([[NC DHHS DMA]]); the [http://www.dhhs.state.nc.us/dma/ NC DHHS DMA home page] appears to also be the focal point for information about both Medicaid in NC and another program called [[NC Health Choice for Children]] (NCHC, NC's version of [[SCHIP]]) which "provides funding to extend health care coverage to roughly 115,000 children each month whose family income exceeds Medicaid financial eligibility criteria".
 ===Eligibility - EIS===
 There does not appear to be any human-readable manual or official rules for determining eligibility for NC Medicaid; rather, eligibility is determined through entering the potential client's information into a mainframe-based computer program called the [[/EIS|Eligibility Information System]] (EIS).
+There is a single-page "[http://www.durhamcountync.gov/departments/dssv/Documents/medicaid_desk_reference.pdf desk reference]" covering basic eligibility requirements, but it does not handle all cases (e.g. maximum qualifying income for more than 2 children).
+===Local Contacts===
+Medicaid applications and hearings are administered by each county's [[North Carolina Department of Social Services|Department of Social Services]]. The [http://www.ncdhhs.gov/dss/local/ directory] sometimes has outdated links.
+* {{instate|Durham County|NC}}: [[Durham County Department of Social Services]]
+** <s>[http://www.durhamcountync.gov/departments/dssv/Financial_Support/Medicaid.html Medicaid]</s> (durhamcountync.gov seems to be down as of 2015-07-14)
+==Stories==
+* [[htwiki:Josh/Medicaid|Josh]]: a tale of first being denied for having filled out the wrong form, and then being denied for not having turned in documentation even though they never told us they were missing it and wouldn't respond to phone calls. As of this writing, we're being told we have to apply for a third time, and we still don't know what documentation is missing. --[[User:Woozle|Woozle]] 17:05, 7 August 2008 (EDT)
 ==Notes==
-When we were applying for Medicaid for a disabled ([[autistic]]) child, our [[case manager]] stated (and insisted, when we questioned the choice) that "Application for Assistance for Adult Medicaid" (DMA-5000[-ia]) was the correct form to use for applying; this turned out to be [[htwiki:Josh/Medicaid|in error]]. The correct form is apparently "Health Check/NC Health Choice for Children Information and Application" (DMA-5063[-ia]). In other words, children ''always'' go through [[NC Health Choice for Children]] -- or perhaps this is only if the parents' income is too high to qualify for regular Medicaid, but the questions on the Adult Medicaid form simply don't make sense when applying on behalf of a disabled child. --[[User:Woozle|Woozle]] 07:32, 11 June 2008 (EDT)
+Apparently children ''always'' go through [[NC Health Choice for Children]], or perhaps only if the parents' income is too high to qualify for regular Medicaid. In any case, the questions on the Adult Medicaid form simply don't make sense when applying on behalf of a disabled child. --[[User:Woozle|Woozle]] 07:32, 11 June 2008 (EDT)
+Confirmed: [[htwiki:Josh|Josh]] ultimately got [[htwiki:Josh/Medicaid|Medicaid]] by applying using a Health Choice/Health Check application. --[[User:Woozle|Woozle]] 16:07, 29 December 2009 (UTC)
 ==Links==
 ===Official===
@@ Line 14: / Line 34: @@
 * [http://info.dhhs.state.nc.us/olm/manuals/dma/fcm/man/ Family and Children's Medicaid Manual] (does not apply for Aged, Blind and Disabled; those are under Adult, as explained [http://info.dhhs.state.nc.us/olm/manuals/dma/abd/man/MA500.htm here])
 * [http://info.dhhs.state.nc.us/olm/manuals/dma/abd/man/MA200.htm Adult Medicaid Manual MA-200: DEFINITIONS]: extensive list of acronyms and program names
+===News===
+* [https://www.healthinsurance.org/north-carolina-medicaid/ North Carolina Medicaid]
+** '''2017-01-04''' [http://archive.is/h06t9 New governor vows to expand Medicaid unilaterally; Republican lawmakers fighting him]
+* '''2016-12-07''' [http://www.newsobserver.com/news/business/health-care/article119509213.html NC health plan to cover sex changes, if medically necessary, in 2017] ([http://archive.is/19o6P archive])