Medicaid Eligibility l Low-income by federal poverty level (FPL) l Us citizen or lawful immigrant l Pregnant Women and newborn l Children 18 years and younger (some states cover up to 21 yrs of age) l Aged, Blind, and/or Disabled

NC Medicaid Co-payment Amounts ServiceCo-payment Amount Chiropractor visit$1.00 Dental visit$3.00 Optical service$2.00 Optometrist visit$2.00 Outpatient visit$3.00 Physician visit$3.00 Podiatrist visit$1.00 Prescription drug$1.00

NC State Children’s Health Insurance Program l Cover families up to 200% of Federal Poverty Level (FPL) l Benefits package provided by NC Teacher’s and State Employees Comprehensive Major Medical Plan plus dental, vision, and hearing

NC State Plan (cont) l Families above 150% pay co-payments $6 for prescription $5 for physician, clinic, dental, and optometry visits $5 for outpatient hospital visit $20 co-payment for unnecessary emergency room use

NC State plan (cont) l Enrollment fee for those above 150% of FPL $50 per child per year $100 maximum for 2 or more children Allow families whose income increases above 200% of FPL to buy into the program for 1 year at full cost

Income Limits: Health Choice for Children (Effective April 2009) Family Size200% FPL Monthly Income 200% FPL Annual Income 150% FPL Monthly Income 150% FPL Annual Income 1$1,805$21,660$1,354$16,245 2$2,429$29,140$1,822$21,855 3$3,052$36,620$2,289$27,465 4$3,675$44,100$2,757$33,075 5$4,299$51,580$3,224$38,685 6$4,922$59,060$3,692$44,295 7$5,545$66,540$4,159$49,905 8$6,169$74,020$4,627$55,515

Estimate of Children Eligible for Medicaid but Not Enrolled CountyUncovered Child Medicaid Eligibles Alamance788 Durham1,292 Forsyth1,703 Guilford2,863 Mecklenburg3,761 Orange488 Randolph1,116 Rockingham722 Wake2,909