If you meet eligibility requirements, Medicaid will pay for some portion of your cost of care in a long term skilled or intermediate care facility as well as medical expenses.
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Medicaid pays the medical provider directly. No payment is made to the recipient. Persons residing in Adult Care Homes (often called rest homes) may be eligible for a check under the Special Assistance Program to help pay for their monthly cost of care in the home. Clients who qualify for Work First Family Assistance “WFFA” get a check.
Medicaid pays for covered medical and health care services for eligible families with children and for adults who are:
Resources are considered when determining eligibility for most programs. Income limits are based on the federal poverty level and range from 100 to 200% of the federal poverty level depending on the program for which you are eligible.
Call the Primary Health Plan that is on your Medicaid card. If you are not enrolled with a plan, call Social Services at 910-798-3500 option 4.
As defined by Social Security, it is a physical or mental impairment which prevents an individual from engaging in any substantial, gainful activity, and which has lasted or is expected to last for at least 12 months, or is expected to result in death. To apply for disability benefits, you must apply through the Social Security Administration offices, 800-772-1213 or 800-325-0778 (TTY).
Medicaid benefits and eligibility vary according to a person’s circumstances and what Health Plan you are linked to. If you are not linked to a Health Plan you should call the Enrollment Broker to see what your options are based on the Health Plan you choose. https://ncmedicaidplans.gov/enroll/online/find/find-provider?lang=en
If you receive CAP or are in a long term care facility, estate recovery may apply to you. This means at the time of your death the government may make a claim against your estate to recover the money paid to medical providers on your behalf.