Who qualifies for emergency Medicaid in NC?

In the State of North Carolina, those categories include:

  • Age 65 or older.
  • Blind or disabled.
  • Infants and children under the age of 21.
  • Low-income individuals and families.
  • In need of long-term care.
  • Receiving Medicare.

What is a NC MCO?

Local Management Entities/Managed Care Organizations (LME/MCOs) manage the care of NC Medicaid beneficiaries who receive services for mental health, developmental disabilities or substance use disorders. The following contracts and reports are related to NC Medicaid.

What are the different types of Medicaid in North Carolina?

Within the State of North Carolina, there are actually several different types or categories of Medicaid as well, including: Families with dependent children; infants and children; pregnant women; and aged, blind, and disabled. The eligibility guidelines vary somewhat within the programs.

How long does it take to get Medicaid approved in NC?

If you are 65 or older, a child, or caretaker of a child, it can take up to 45 days to process your application. If you are under age 65 and have no child in your care, it can take up to 90 days to process your application. If we need additional information, we will contact you by telephone or mail.

What all does NC Medicaid cover?

Medical benefits and services include:

  • Ambulance services.
  • Cardiac procedures.
  • Certified pediatric and family nurse practitioner services.
  • Chiropractic services.
  • Clinic services.
  • Dietary evaluation and counseling and medical lactation services.
  • Durable medical equipment.

How many MCOs are in North Carolina?

On July 1, North Carolina’s Medicaid program transitioned from a system run and managed primarily by the state, to a system run and managed by five different private insurance companies, called managed care organizations or MCOs.

Do I qualify for Medicaid in North Carolina?

Eligibility depends on your child’s age, family size, income and resources. Visit the NC Medicaid and Health Choice website to learn about eligibility….Who is eligible for NC Medicaid/Health Choice?

Monthly Income Limits: Medicaid for Infants and Children
1 $2,254 $1,428
2 $3,049 $1,931
3 $3,843 $2,434
4 $4,638 $2,938

Can a Adult qualify for Medicaid in NC?

Seniors can apply for Medicaid in North Carolina online at ePASS, in person at their local Division of Social Services (DSS) office, or print and submit a completed Medicaid application to their local DSS office.

What is the state guide to CMS criteria for managed care?

1 The guide is intended to provide transparency on the criteria for contract approvals and to help states verify that contracts with Medicaid managed care entities meet all CMS requirements. 2 This guide is an update to the 2015 State Guide to CMS Criteria for Managed Care Contract Review and Approval.

How do I contact NC Medicaid Managed Care?

Call us to get answers to your questions about NC Medicaid Managed Care. The call is toll free. Phone: 1-833-870-5500 (TTY: 711 or RelayNC.com) Hours of operation: 7 a.m. to 5 p.m., Monday through Saturday

What are the requirements of the MCP’s managed care contract?

The contract requires the MCP to have written policies guaranteeing each enrollee’s right to receive information on the managed care program and plan into which he/she is enrolled. [42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(i)] [Existing standard]

What are the Medicaid requirements for non-contracted hospitals?

Pursuant to state Medicaid Director Letter #06-010, for services provided by non-contracted hospitals, this amount must be less any payments for indirect costs of medical education and direct costs of graduate medical education that would have been included in FFS payments.