If you’ve delayed looking into NC Medicaid because you’re feeling overwhelmed, know that many other North Carolinians are feeling the same way. Once you learn about the program and its terms, NC Medicaid won’t be as complex, and you can take it step by step.
In this resource guide, you’ll learn about the differences between Medicaid and Medicare, NC Medicaid programs and services, and how to apply for NC Medicaid.
Understanding Medicaid and How it Differs from Medicare
Medicaid is a state-run, free assistance program for low-income individuals and families needing healthcare.
Medicare is a federally-run health insurance program for people who are on dialysis, disabled, or over 65.
These programs overlap eligible populations, which means an individual can be a Medicaid and Medicare beneficiary if they meet specific requirements.
NC Medicaid is the general term for Medicaid in North Carolina, and it consists of the following programs, entities, and organizations:
- North Carolina Medicaid is a healthcare program for children, low-income adults, people with disabilities, pregnant women, and seniors.
- NC Health Choice is the Children’s Health Insurance Program (CHIP) for North Carolina.
- LME-MCOs are Local Management Entities - Managed Care Organizations, which are contractors for behavioral healthcare and disability services.
Contacting a Division of Social Services (DSS) Caseworker
Before applying for NC Medicaid, you must contact a North Carolina Division of Social Services (DSS) caseworker. Every county in North Carolina has a DSS agency with caseworkers that can help people with their NC Medicaid eligibility, answer application questions, and more.
To find the contact information of your county’s DSS agency, view the Local DSS Directory.
Check out the video below to learn how to use this directory.
Creating an NCID
Before you can apply, you need an NCID.
To register for an NCID, gather these documents:
- Birth certificate, proof of citizenship, or alien status
- Social Security documents
- Verification of North Carolina residency
- Pay stubs
- Medical or life insurance policies
- Vehicle information
- Bank statements
- Property information
- Documentation of other income sources (if applicable)
Once you have your documents together, go to NCID and click Register! then follow along with the NCID User Guide beginning on page 18, Section 2.2.
Applying Using ePASS
After getting your NCID, visit ePASS to access the NC Medicaid application.
Check out the video below to see how the ePASS website works.
If you prefer to fill out a paper application, you can access it here: Medicaid and NC Health Choice Applications.
Once your NC Medicaid application is approved, click the video below to learn how to navigate the NC Medicaid site.
Canceling NC Medicaid
To cancel, either send a request in writing or over the phone to your county’s DSS office.
Reporting Medicaid Fraud/Abuse
Check out Office of Compliance and Program Integrity - OCPI/Fraud Waste and Abuse to complete an online form or call the phone number for Medicaid reporting.
The Medicare Resource Guide is coming soon!