Medicaid is a nationwide program that provides low-income Americans with access to essential health services. It’s jointly funded by the federal and state governments and administered by each state.
By law, every Medicaid plan must include coverage for hospital, physician, home health and nursing facility services. Optional benefits, such as vision and dental care, hospice care, adult day health and case management, may be provided through state-specific programs
In North Carolina, Medicaid is administered through the NC Medicaid Division of Health Benefits. To qualify for coverage that includes access to Medicaid waivers, seniors aged 65 and older can earn up to $1,041 per month ($2,082 per married couple) and own up to $2,000 in countable assets ($3,000 per married couple). Applicants must also be U.S. citizens or qualified immigrants, have a valid Social Security number and be permanent residents of the state.
Personal Care Services
Seniors who meet Medicaid enrollment criteria and need help with two or more activities of daily living due to disability, chronic illness or age-related deterioration may be eligible for the Personal Care Services program.
This Medicaid home and community-based program funds up to 3.5 hours per day and 60 hours per month of personal care, allowing seniors to remain in their home or an approved assisted living facility.
The five activities of daily living covered under this program include dressing, eating, using the toilet or managing a colostomy bag, grooming and moving about the home. Seniors may also receive assistance with housekeeping if that assistance is directly related to the qualifying ADLs. For example, a PCS-funded aide may clean the bathroom after helping a senior use the toilet or take a bath.
To qualify for PCS or PCSP services, seniors must:
- Need extensive hands-on help to perform at least one of two ADLs, or
- Need some help to complete at least three ADLs, or
- Be entirely dependent on another person for help performing at least one of two ADLs
As an entitlement program, all applicants who meet enrollment criteria are provided with services.
To learn more about NC Medicaid and the PCS/PCS Plus program, contact the
Carteret County Department of Social Services at (252) 728-3181.