Family & Children's Medicaid

The new Family and Children's Health Care Program handbook is now available for consumer use. Please click here.

 

MEDICAID FOR FAMILIES AND CHILDREN

 Families, children and infants are served by Medicaid with several programs:

  • Medicaid for Infants and Children (MIC)
  • Medicaid for Families with Dependent Children (MAF) children
  • Medicaid for Pregnant Women (MPW)
  • Family Planning Medicaid (FPW)
  • Community Alternatives Program (CAP/C)
  • Medication Assistance Prescription Program (MARP)
  • Breast and Cervical Cancer Medicaid (BCCM)
  • Health Coverage for Workers With Disabilities (HCWB)


Your family’s income, the number of people in your family, and the age of the children in your family determine if you or your family qualify and which program you may receive.

When you apply for Medicaid, your family’s monthly income is calculated by subtracting certain deductions from your gross income. Deductions are given for work-related expenses, child care costs, and court-ordered child support or alimony payments. The allowed deductions vary with each Medicaid program. Your county worker will calculate your monthly family income based on the circumstances of your individual case. 

Not all programs provide full coverage of services. That, too, varies with each program. Your county worker will explain which program(s) you may qualify for and what coverage the program provides. 

 

MEDICAID FOR INFANTS AND CHILDREN (MIC)

 Medicaid for Infants and Children provides medical coverage for children under age 19. The income limits are determined by the age of the children in the family. There is no limit on resources.

 Monthly Income limits effective April 1, 2013:

Family size:        Up to Age 1        Age 1 to 5          Age 6 to 18

        1                $1,772                 $1,915              $958

        2                $2,392                 $2,585               $1,293

        3                $3,011                 $3,255               $1,628

        4                $3,631                 $3,925               $1,963

        5                $4,251                 $4,596               $2,298

For each additional member add:

                          $620                    $670                    $335                                             

 If the family income is greater than the amounts listed above, the child(ren) may be eligible for NC Health Choice for Children.

 NC Health Choice for Children is an insurance program for children who do not qualify for Medicaid and do not have private insurance coverage.  There may be enrollment fees and co-payments for medical services.  

MEDICAID FOR FAMILIES WITH DEPENDENT CHILDREN (MAF)

Medicaid for Families with Dependent Children provides medical coverage for parents and other caretakers or relative with children  age 18 and under, as well as for children under age 21. A pregnant woman may also qualify.

The family cannot have more than $3,000 in assets, such as money in savings and checking accounts. 

Monthly Income limits effective April 1, 2013 are:

Family Size         Income Limit

1                         $362

2                         $472

3                         $544

4                         $594

5                         $648

(for each additional member add $50.00)

If your family is over the income limit but have high medical bills, you may still qualify for Medicaid and have a Medicaid deductible, which is the amount you are responsible to pay. 

MEDICAID FOR PREGNANT WOMEN

 Medicaid for Pregnant Women (MPW) pays only for services related to the pregnancy. Application can be made during the pregnancy or up to three months after delivery. A woman who experienced a recent pregnancy loss may also qualify.

There is no limit on resources.

 Monthly Income limits effective April 1, 2013:

Family Size          Income Limit

2                         $2,392

3                         $3,011

4                         $3,631

(unborn child counts in family size).

 If a woman is covered by Medicaid on the date she delivers, her newborn child is covered by Medicaid up to age 1 without a separate application. Please make sure that the hospital has informed your worker that your baby was born. The baby's medicaid will not take effect until the worker is notified by either you, or the hospital.

 

COMMUNITY ALTERNATIVES PROGRAM (CAP/C)

The Community Alternatives Program for Children (CAP/C)  (also known as the Katie Beckett waiver) provides home and community based services to medically fragile children who, because of their medical needs are at risk for institutionalization in a nursing home. Examples of children who may be eligible for CAP/C include children with ventilators, tracheotomies, feeding tubes, severe seizures, and those children who need help with activities such as bathing, dressing, grooming, and toileting when the child, for medical reasons, is not able to do or learn to do those tasks independently.

BREAST AND CERVICAL CANCER MEDICAID

Women between the ages of 18 and 64 who have screened for and diagnosed with breast or cervical cancer by a designated screening provider and does not have health insurance. Applications can only be submitted to the department from these providers.

HEALTH COVERAGE FOR WORKERS WITH DISABILITIES

This program is effective November 1, 2008, and provides an incentive for persons with disabilities to go to work or increase their hours of work while protecting their Medicaid eligibility. The program covers ages 16 through 64 and the individual must have a disability as defined by the Social Security Administration.


Applications for any of the above Medicaid programs can be made by submitting an application form. (Please click on "application form" to bring up the application to fill out)

Once the form is completed you may bring the application to the Department of Social Services, drop it in the drop box out front, fax to 828-652-9167 or mail to:

McDowell County Department of Social Services
Attn: Phyllis Revis
PO Box 338
Marion, NC 28752

If you would like to fill out an application electronically through the epass website, please click here. Please note that the application can not be submitted yet, so you will need to bring the application by DSS, mail it in, or fax.

 

En Espanol:

http://info.dhhs.state.nc.us/olm/forms/dma/dma-5063sp.pdf

http://info.dhhs.state.nc.us/olm/forms/dma/dma-5065sp.pdf

http://info.dhhs.state.nc.us/olm/forms/dma/dma-2188sp.pdf

 

 

 

 

 

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