NC Medicaid is a public insurance program that provides health coverage for low-income adults, pregnant women, children, elderly adults and other eligible Americans. States are required to provide certain mandatory benefits to Medicaid recipients, such as physician services, inpatient and outpatient hospital services and prescriptions, and Medicaid may opt to provide additional benefits, including nursing home care, personal care and medical equipment.
Seniors in Durham may be eligible for Medicaid if they meet certain financial income and asset requirements. For single seniors, the monthly income limit is $1,012 with assets valued at no more than $2,000, while couples are limited to an income of $1,372 per month and $3,000 in assets. Resources don’t include a senior’s home, car, home furnishings or other necessary items, but it does include cash, bank accounts, stocks and other similar assets.
The state’s Medicaid Deductible plan may help seniors who don’t meet these financial requirements but do have high medical costs. Seniors pay for their own health care costs until they meet their deductible, then Medicaid kicks in.
Seniors who are interested in Medicaid coverage can apply through the North Carolina ePass online portal. They can also choose to complete a paper application and take or mail it to:
Durham County Department of Social Services
414 E Main St, Durham, NC 27701.
Seniors who need help applying for Medicaid or have questions can call (800) 662-7030.
North Carolina’s Personal Care Services (PCS) program may cover hands-on personal care for seniors who live in assisted living facilities. This program is considered an entitlement since it’s offered under North Carolina’s Medicaid State Plan, and the need for assistance is determined by an independent medical assessment performed by the Division of Medical Assistance (DMA). To be eligible for support through the PCS program, seniors must need help with three activities of daily living (ADLs), which are defined as eating, dressing, bathing, toileting and mobility. Alternately, seniors who need assistance with only two ADLs may qualify if their need is extensive.
To apply for the PCS program, fax a paper application form to the Liberty Healthcare Corporation at (919) 307-8307. Seniors must have parts of the form completed by a doctor. Seniors who have questions about this program can call (855) 740-1400.