What is Changing?
NC has not terminated anyone from Medicaid since 2020 because of the COVID-19 pandemic. Starting April 1, 2023 your local DSS office will begin checking to see if you are still eligible for Medicaid. If it determines that you are no longer eligible, your benefits may end or be reduced.
- Make sure DSS has your current mailing address, phone number, email, and other contact information.
MAKE SURE YOU:
- Check your mail! DSS may mail you a letter about your Medicaid coverage.
- Complete and return any forms that you receive from DSS.
IF YOUR MEDICAID HAS BEEN TERMINATED, YOU HAVE OPTIONS:
- If you do not understand why you have been terminated, contact your local DSS or visit www.ncmedhelp.org to get more information.
- If you do not agree with the termination, you can appeal the decision at your local DSS. Visit ncmedhelp.org to learn how to receive free legal help.
- If you no longer qualify for Medicaid, you might qualify for an ACA Marketplace plan with significant discounts or subsidies. Visit the North Carolina Navigator Consortium at ncnavigator.net to receive free help.
Did you know?
You can find you local DSS office HERE
Be sure to open any letters from DSS and read them carefully because it might have very important information about your Medicaid coverage. If you do not understand anything in the letter, you can call your caseworker for help.
Your local DSS will not send you anything unless they need information from you to complete your recertification or your benefits were continued, terminated, or changed. If you did not get anything in the mail but your provider or health plan said you no longer have Medicaid, contact your local DSS right away.
– People who have turned 19 since 2020 and are no longer eligible for Medicaid as children;
– Parents or caregivers of children who have turned 19 since 2020;
– People who have had household income changes (like a new job) that place them above the income cutoffs;
– Women who had a baby more than a year ago and were covered through the Medicaid for Pregnant women (MPW) program;
– People who have lost Supplemental Security Income (SSI) during the pandemic.
Yes. You can use the enhanced e-pass system to view your benefits, notify DSS of changes, and make sure your information is correct.
If you believe that DSS has denied you for Medicaid in error, you have a right to an appeal. You can visit ncmedhelp.org for more information.
– You should contact your DSS caseworker immediately for help. If they are unable to assist you, you can visit ncmedhelp.org for additional resources.
– You have 60 days from the date on the notice to ask for an appeal. If you file within 10 business days of the notice, you can request that your Medicaid be continued while you appeal is reviewed.
Medicaid expansion has not passed yet. If it is approved, more information will be shared by NC Medicaid on this topic. For now, watch for information from your local DSS related to your Medicaid benefits.