Family & Children's Medicaid

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)
• Medicaid for Pregnant Women (MPW)
• Family Planning Medicaid (FPW)
• Community Alternatives Program (CAP/C)
• 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.  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, 2024:

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

        1                $2,649             $2,649              $2,649

        2                $3,595              $3,595             $3,595

        3                $4,541             $4,541              $4,541 

        4                $5,486             $5,486             $5,486

        5                $6,432               $6,432              $6,432

For each additional member add:

                          $946                 $946                 $946                              
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 under 18 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. (If client is eligible under traditional rules)

Monthly Income limits effective April 1, 2024 are:

Family Size         Income Limit

1                         $434

2                         $569

3                         $667

4                         $744

5                         $824

(for each additional member add $78.00)

If your family is over the income limit but has 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, 2024:

Family Size          Income Limit

2                         $3,339

3                         $4,218

4                         $5,096

5                         $5,975

6                         $6,854

(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) If you would like to complete the Spanish application, click here.

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
PO Box 338
Marion, NC 28752

If you would like to fill out an application electronically through the epass website, please click here

.