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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 N.C. Health Choice 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

Click below to get to desired table:

Note: These categories apply to N.C. Health Choice Only. Except for MIC-1, N.C. Health Choice only covers children aged 6-18.

N.C. Health Choice Categories

MIC-A

MIC-A covers individuals with incomes of 150% or less of the poverty income level who are members of a federally Recognized Native American Tribe or Alaskan Native.

 MIC-J

 

MIC-J covers individuals with incomes of 150% or less of the Federal Poverty Income Level.

MIC-K

MIC-K covers individuals with incomes in excess of 150% up to 200% of the Federal Poverty Income Level.

MIC-S


MIC-S covers individuals with incomes between 151% and 200% of the Federal Poverty Income Level who are members of a Federally Recognized Native American Tribe or Alaskan Native.

MIC-L

MIC-L is optional extended coverage for children through age 19 who were currently receiving N.C. Health Choice but income at enrollment is now greater than 211% but equal to or less than 225% of the Federal Poverty Level.

The family have the option to pay monthly premiums for the child(ren) to remain on NC Health Choice for an additional 12 month period. Families are not allowed to re-enroll into Optional Extended Coverage.  A family may only qualify for Optional Extended Coverage again if they later receive NC Health Choice for Children for another 12 month enrollment period, and, are again ineligible for NC Health Choice for Children at re-enrollment due to increased income. 

When a child(ren) is approved for the Optional Extended Program, DMA will send an offer letter to the family to notify the family the cost of the monthly premium payments and give the family the option to pay the premiums. The family is not “locked in” to Optional Extended Coverage during the certification period.  The family can contact the county Department of Social Services and reapply for Medicaid or NC Health Choice at any time.

Families are encouraged to compare the State’s premium to their employer’s insurance, on-line insurance companies, or at the affordable healthcare portal www.healthcare.gov.

MIC-1

Medicaid Expansion Groups:

  1. Children 0 – 12 months of age with family income between 186% and 200% of the federal poverty income level; and
  2. Children 13 months – 5 years of age with family income between 134% and 200% of the federal poverty income level.

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