Medicaid

Preparing for the End of the COVID-19 Federal Public Health Emergency

Since it began in January 2020, the COVID-19 federal Public Health Emergency (PHE) helped prevent NC Medicaid beneficiaries from losing their health coverage during the pandemic, even if someone’s eligibility changed. The PHE also helped health care providers keep their practices running so they could deliver care to Medicaid beneficiaries.

The federal PHE currently extends through Oct. 13, 2022. While we do not know when the PHE will end, NC Medicaid wants to help beneficiaries, providers and community stakeholders understand any potential impacts and steps they can take to be ready. 

NC Medicaid has launched a new webpage to help provide guidance on preparing for the end of the PHE. The webpage offers information and resources including a communication toolkit for community partners who work closely with beneficiaries as we work together to ensure consistent access to care.

Visit NC Medicaid Division of Health Benefits for more information
Mother with child at the doctor

Medicaid is a medical assistance program that serves children, adults and families.

Medicaid will pay medical bills for people who meet certain eligibility requirements such as income, age or disability. Covered services include hospitalizations, physician services, medications and different levels of care in nursing and residential facilities.

Apply Online Report Changes

Introduction to NC Medicaid Managed Care (English)

Introduction to NC Medicaid Managed Care (Spanish)

Learn about NC Medicaid Managed Care

Do you have Medicaid now and ready to enroll in a Medicaid Managed Care Plan?Enroll in NC Medicaid Managed Care 

NC Medicaid Ombudsman

The NC Medicaid Ombudsman is an advocate for beneficiaries to provide free, confidential assistance to educate and empower people with Medicaid during the change to Medicaid Managed Care. The Ombudsman also connects people to resources like social services, housing resources, food assistance, legal aid and other programs.
NC Medicaid Ombudsman

Learn more about Medicaid Programs

Family and Children’s Medicaid

  • Covers children through age 20, parents and caretakers of minor children under the age of 18, and pregnant women who meet income requirements.
  • Family Planning Program (FPP) is designed to reduce unintended pregnancies and improve the well-being of children and families. Services are provided to eligible persons of any age who are ineligible for all other Medicaid programs.
  • North Carolina Health Choice (NCHC) Health Insurance for Children provides reduced price comprehensive coverage for children six to 18 years whose family income meets certain limits but is too high to qualify for Medicaid.

Adult Medicaid

  • Provides coverage for disabled or blind persons of any age and adults aged 65 or older. There are income and reserve limits for these programs.
  • Private Living Assistance (PLA) Medicaid covers individuals or couples living in their own homes or apartments, or in the homes of relatives or friends.
  • Special Assistance coverage helps pay the cost of care for adults over the age of 18 living in an adult care home, rest home or other assisted living facility.
  • Special Assistance-In Home offers monthly payments to help individuals at risk for adult care home placement to continue living at home.
  • Long Term Care (LTC) Medicaid helps pay for care in a nursing home or intermediate care facility. Learn more about Long Term Care Medicaid.

Community Alternatives Program (CAP) and Program of All-inclusive Care for the Elderly (PACE)

  • Community Alternatives Program (CAP) and Program of All-Inclusive Care for the Elderly (PACE) provide home and community-based services that allow Medicaid beneficiaries who require nursing home care to live safely at home
  • Learn more about the Community Alternatives Program
  • Learn more about PACE

Medicare-Aid for Qualified Beneficiaries (MQB)

  • MQB is a limited assistance program for individuals enrolled in Medicare Part A and/or Medicare Part B.
  • MQB helps pay for Medicare premiums and in some cases, Medicare coinsurance and deductibles.
  • If found eligible for MQB, the process usually takes three to four months to receive coverage. Any premiums deducted from a Social Security check that the State is responsible for paying, will be reimbursed. If Medicaid stops for any reason, Medicaid will no longer pay the Medicare premium.
  • To participate in MQB, individuals must apply for Medicaid first. There is not a separate application process for MQB.

Notice: To persons who have had or may in the future have their Medicaid benefits terminated or reduced in North Carolina

Franklin et al. v. Kinsley, formerly known as Hawkins et al. v. Cohen, is a federal lawsuit filed in 2017. This case was certified by the Court as a class action lawsuit on behalf of N.C. Medicaid beneficiaries.

Proposed Settlement of Franklin et al. v. Kinsley

Contact Us

Call: 919-212-7000
Fax: 919-212-7028
Mail:
Wake County Health & Human Services
P.O. Box 46833
Raleigh, NC 27620