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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 
NC Division of Medical Assistance - High quality health care through Medicaid and Health Choice for Children.

Este programa En EspanolGlossary of General Medicaid Terms

"The Partnership for a Healthy NC" (Medicaid Reform)

Click here to learn more about Medicaid Reform

Those who want a more detailed explanation of the various Medicaid programs for families and children are encouraged to read A Consumer's Guide to N.C. Health Care Coverage Programs for Families and Children

Those who want a more detailed explanation of the various Medicaid programs for the elderly, blind and disabled are encouraged to read Health Insurance Programs for the Aged, Blind and Disabled

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GLOSSARY OF GENERAL MEDICAID TERMS

Community Alternatives Program (CAP)

CAP programs help people who need long-term care stay in their own homes. CAP provides both medical and non-medical services to prevent or delay care in a facility. CAP participants must meet all Medicaid eligibility requirements. CAP categories are:

  • CAP for Individuals with Intellectual and Developmental Disabilities (CAP-I/DD)
  • CAP for Children (CAP-C)
  • CAP for Disabled Adults (CAP-DA)
    • CAP-Choice, an option under the CAP/DA program, is consumer-directed care for disabled adults who wish to remain in their own home and have increased control over their own services and supports.

'Be Smart' Family Planning Program

The 'Be Smart' Family Planning program provides family planning services to eligible men ages 19-60 and eligible women ages 19-55.

Community Care of North Carolina/ Carolina ACCESS (CCNC/CA)

CCNC/CA is North Carolina’s Medicaid managed care program which provides beneficiaries with a medical home and a primary care provider (PCP) who coordinates medical care.

Health Coverage for Workers with Disabilities (HCWD)

Under HCWD individuals with disabilities may be able to go to work or increase their hours of work and still receive Medicaid services. HCWD provides full Medicaid coverage for workers with disabilities age 16 through 64 who meet enrollment criteria. HCWD beneficiaries aged 16-21 may also receive Health Check/EPSDT services.

Health Check/EPSDT (Early and Periodic Screening, Diagnosis, and Treatment)

Health Check/EPSDT covers medical and dental services for people between the ages of 0-21. Sick visits and well visits (check-ups) are covered, as well as medically necessary services ordered by a doctor.

In Home Care (IHC)

In Home Care is person-to-person hands-on assistance with common activities of daily living (ADLs), such as bathing, dressing, toileting, and taking and recording of vital signs. Two programs are available: IHC for Adults (IHCA) age 21 and over and IHC for Children (IHCC) under age 21.

Long Term Care

Long-term care defines a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods of time. Examples include skilled nursing facilities (SNF or nursing homes), adult care homes or in home care.

Medicaid

Medicaid provides health care coverage for low-income individuals and families who can't afford health care costs. Medicaid serves low-income parents, children, seniors and people with disabilities. Medicaid is governed by both federal and state laws.

Money Follows the Person (MFP)

MFP provides Medicaid-eligible beneficiaries with the supports they need to return to their own homes and communities.

N.C. Health Choice for Children (NCHC)

NCHC is a health coverage program for low-income children. Families which make too much money to qualify for Medicaid, but too little to afford private or employer-sponsored health insurance, may have children who qualify for NCHC.

Personal Care Services

PCS provides individuals with hands-on help with activities of daily living (ADL) such as bathing, grooming, dressing, toileting and meal preparation. Such care may be provided in the home or in a facility.

Program for All-Inclusive Care for the Elderly (PACE)

PACE is a managed care program that allows elderly Medicaid-eligible individuals who need nursing facility care to live in a private living arrangement and have their medical needs met by a PACE agency.

Temporary Assistance for Needy Families (TANF)

A cash payment program for families with children. It is also known as Work First Family Assistance (WFFA). Those eligible for TANF are automatically eligible for Medicaid.

Work First Family Assistance (WFFA)

A cash payment program for families with children. It is also known as Temporary Assistance for Needy Families (TANF). Those eligible for WFFA are automatically eligible for Medicaid.

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