Information for Medicaid Consumers

Medicaid is a health insurance program for low income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.

Medicaid is a little different, depending on who you are and your situation.

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Adults | Families and Children | Long-Term Care
Medicare Recipients | Your Rights | Helpful Sites and Resources

Adults

• Adult Medicaid Frequently Asked Questions
• Aged and Disabled Fact Sheet
• Community Alternative Programs
• Consumer Guide: Health Insurance Programs for the Aged, Blind, and Disabled (1.9 MB PDF)

Families and Children

• Family and Children's Medicaid Frequently Asked Questions
• Baby Love: The Baby Love program is a combination of services designed to help you have a healthy baby.
• Be Smart Family Planning:The Be Smart Family Planning Program is designed to reduce unintended pregnancies and improve the well-being of children and families in North Carolina.
• CAP/C: The Community Alternatives Program for Children (CAP/C) provides home and community-based services to children who are medically fragile. The program is meant for children who might otherwise go into a nursing home.
• CSCP: The Child Service Coordination Program (CSCP) is a free and voluntary program that helps families like yours find and use community services. 
• Health Check and EPSDT: Health Check is Medicaid for children. Health Check covers complete medical and dental check-ups, and provides vision and hearing screenings and referrals for treatment. EPSDT is the federal law that requires Medicaid to provide medically necessary health care services to Medicaid-eligible children through the age of 20 even if the servcies are not normally covered by Medicaid or the services are normally only covered for recipients 21 years of age and older.
  • Health Check Coordinators (149 KB PDF)
• Health Choice: North Carolina Health Choice (NCHC) is a free or reduced price comprehensive health care program for children.  If your family makes too much money to qualify for Medicaid but too little to afford rising health insurance premiums, your child(ren) may qualify for NCHC.
• Online Resources for Families and Children
  • Consumer Guide: Health Insurance Programs for Families and Children (727 KB PDF)
  • N.C. Healthy Start Foundation

Long-Term Care

• Financial Rules for Long-Term Care Medicaid Recipients
• Long-Term Care Frequently Asked Questions
• Online Resources for Long-Term Care
  • Duke Long-Term Care Resources Program
  • NC DHHS Long Term Care Web Site
  • Medicare Nursing Home Compare

Medicare Recipients

• Aged and Disabled Fact Sheet
• Frequently Asked Questions
• Medicare-Aid Fact Sheet
• Medicare-Aid for Working Individuals Individuals With a Disability Fact Sheet
• Medicare Part D: Prescription Drug Plan Program
• Online Resources for Medicare Recipients
  • Consumer Guide: Medicare Savings Programs Within North Carolina Medicaid (907 KB PDF)
  • Medicare.gov: The Official U.S. Government Site for People with Medicare
  • NCRx: Governor Easley’s new prescription drug assistance plan to help low-income seniors participate in the federal Medicare Part D prescription drug program.

Your Rights

• Informal Appeal Request Form (DMA-2003) (53 KB PDF)
• Medical Care Decisions and Advance Directives - What You Should Know (23 KB PDF)
• Medical Care Decisions and Advance Directives - What You Should Know en Español (104 KB PDF)
• Notice of Privacy Practices (28 KB PDF)
• Notice of Privacy Practices en Español (28 KB PDF)

Helpful Sites and Resources for Medicaid Consumers

• Achieve Solutions Helpful information for behavioral health from ValueOptions, Inc.
• Federal Medicaid information for consumers
• Hospital Compare: This federal web site lets you see how various hospitals compare in their treatment of adults with heart attacks, heart failure, or pneumonia.