If you are over 65, blind or disabled, the income limit to receive medicaid is equal to 100% of the poverty level. There is a limit on resources.
Can I receive Medicaid if I don’t have children?
Adults (people who are age 21 and over) may be eligible for Medicaid if they are:
- Age 65 or older
What are the monthly income limits for Medicaid for Adults?
Table: Adult Medicaid Monthly Income Limits
|Monthly Income Limit
If monthly income exceeds these amounts the person must meet a deductible based upon the Medically Needy income limits below:
Table: Medically Needy Income Limits
|Monthly Income Limit
What is a deductible?
A deductible in Medicaid works much like a deductible for private insurance. A person is responsible for a certain amount of medical bills before insurance pays. The difference is that a Medicaid deductible is not a set dollar amount (such as $100 or $250). It is based upon the person's income. If income is more than a limit set by law there must be a deductible. The deductible is the amount of income over the income limit. A deductible can be for 1, 2 or 3 months before the month of application or for a period of 6 months beginning with the month you apply.
How do I meet the deductible?
A Medicaid deductible is met by adding up medical costs on a day by day basis. When a Medicaid applicant pays or is billed for medical care, supplies and prescriptions, he has incurred these costs and may have them applied to his deductible. Only the portion of the bill that the person must pay can be applied to the deductible. (For example, a person with health insurance may only be responsible for 10% or $50 of a $500 bill. Fifty dollars is the amount that can be applied to meet the Medicaid deductible.) You can be authorized for Medicaid on the date that the bills add up to the amount of the deductible.
Whose Income/Medical Bills are Counted Toward the Deductible?
In Medicaid, your spouse's income must be counted in determining eligibility. Likewise, a parent's income must be counted when determining eligibility for a child. Because these individuals’ income is counted, their medical bills may be applied to the Medicaid deductible.
How do I apply for Medicaid?
- You may visit the Social Work Services office at:
40 Coxe Avenue
Asheville NC 28802
- You may call DSS at (828) 250-5500 and an application will be mailed to your or you may apply over the telephone.
- You may download an application from ncdhhs.gov/DMA or from the Medicaid page.
What do I need to take to apply for Medicaid?
You are not required to take anything with you when you apply for Medicaid. However, it is helpful if you have your:
- Social Security Number
- proof of your income and information about your resources (such as your bank account number and your insurance policy number.)
- If you are self-employed, your business records and/or tax records would be helpful.
If my income is over the limits and I can’t meet a deductible, are there other programs?
Yes, the following programs are for adults who have Medicare. These programs may be referred to as Medicare Savings Programs.
- The MQB-Q program (or Comprehensive Medicare-Aid) pays the Medicare Part A and B monthly premium, Medicare deductibles, and co-insurance.
- The MQB-B (or Limited Medicare-Aid) program and the MQB-E (Limited Medicare-Aid Capped Enrollment) program both pay the Medicare Part B monthly premium.
- MWD pays the Medicare Part A premium for disabled individuals who have lost eligibility for Medicare Part A due to earnings greater than the amount allowed by the Social Security Administration.
- Some individuals who live in nursing homes qualify for Medicaid to pay for their cost of care. In addition, some individuals who are in need of nursing care can receive benefits under the Community Alternatives Program (CAP), which enables the person to stay home and receive needed services. There are additional requirements that must be met to qualify for these extra services. For example, there must be documented proof that the individual has a medical need for the services.
- Some individuals in adult care homes (rest homes) are eligible for a check from the Special Assistance program to help pay for their care in the home. These individuals also receive Medicaid to help pay for their medical care.
Individuals who qualify for certain cash assistance programs automatically qualify for Medicaid without a separate application. If cash assistance ends, the Medicaid may be continued if the individual meets the eligibility criteria for another type of Medicaid. The programs which include automatic Medicaid are:
- Supplemental Security Income (SSI) for elderly, blind and disabled individuals
- State/County Special Assistance (SA) assistance for payment of rest home expenses for elderly, blind and disabled individuals