| 2024 MAGI MEDICAID & MEDICAID EXPANSION INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 224 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| 2025 MAGI MEDICAID & MEDICAID EXPANSION INCOME LIMITS | Family and Children's Medicaid | | pdf | 89 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | |
| 2025 NON-MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid | | pdf | 145 KB | | adult-medicaid health-benefits-nc-medicaid | |
| 2026 Basic Medicaid Eligibility Requirements | Basic Medicaid Eligibility Requirements, Health Benefits/NC Medicaid | Manual | pdf | 157 KB | | basic-medicaid-eligibility-requirements health-benefits-nc-medicaid | manual |
| ADULT MEDICAID TABLE OF CONTENTS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 126 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| Attachment – DHB Self-Attestation | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 240 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| CHANGE NOTICE FOR MANUAL NO. 01-05, Case Mix | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 19 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-11, Series # 3 Of Corrections, Additions, Deletions And/Or Updates, & Figures/Attachments Removal | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 31 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-14, HCWD Phase III | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 80 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-15, Non-Emergency Medicaid Transportation | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 16 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-15, Non-Emergency Medicaid Transportation | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 16 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-16, Alien Requirements | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 81 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-16, Alien Requirements | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 142 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-17, HCWD Premiums And DDS Address Change | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 28 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-17, Medicaid/NCHC Income/Reserve Limit Charts | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 78 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-19, Enumeration | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 44 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-19, Enumeration | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 170 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-20, 2020 Federal Poverty Level (FPL) Changes | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 108 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-20, 2020 Federal Poverty Level (FPL) Changes | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 210 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-21, Breast and Cervical Cancer Medicaid | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 190 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-21, Changes Related To 2021 Cost-Of-Living Adjustment (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 301 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-22, 2022 Federal Poverty Level Changes | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 233 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-22, Reasonable Compatibility – Corrections and Additions | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 174 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-23, Reasonable Compatibility | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 138 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-23, Reasonable Compatibility | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 240 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-24, 2024 Pickle Amendment | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 150 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-24, MA-3200, Application | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 360 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-25, 2025 Federal Poverty Level (FPL) Income Changes | Family and Children's Medicaid | Change Notice | pdf | 266 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-25, 2025 Pickle Amendment | Adult Medicaid | Change Notice | pdf | 164 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-26, 2026 Pickle Amendment | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 108 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 01-26, MA-3240 Pregnant Woman Coverage | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 167 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-10, LIS Application For Medicaid | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 22 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-11, Long Term Care Partnership Program | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 35 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-12, Various Changes For 1/1/12 | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 60 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-14, FPL Income Limit Changes | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 51 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-18, Community Spouse Resource Allowance And Low-Income Subsidy | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 14 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-19, Aged, Blind, And Disabled Medicaid Table Of Contents And Non-Magi Medicaid Income/Reserve Limits | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 24 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-19, Breast And Cervical Cancer Medicaid (BCCM) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 139 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-21, Adult Medicaid Table of Content | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 224 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-21, Family and Children’s Medicaid Table of Contents | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 225 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-22, 2022 Federal Poverty Level Changes (FPL), Cost of Living Adjustment (COLA) Disregard and Low Income Subsidy (LIS) Income Limits | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 182 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-22, Money Follows The Person | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 336 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-23, 2023 Federal Poverty Level (FPL) Changes,Cost of Living Adjustment (COLA) Disregard and Low Income Subsidy (LIS) Income Limits | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 232 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-23, Modified Adjusted Gross Income Budgeting | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 239 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-24, Change in Circumstance, Terminations, and Reopening | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 357 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-24, MA-2300, Application | Adult Medicaid | Change Notice | pdf | 155 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-25, 2025 Community Spouse Resource Allowance | Family and Children's Medicaid | Change Notice | pdf | 130 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-25, 2025 Federal Poverty Level Changes (FPL) Income Changes | Adult Medicaid | Change Notice | pdf | 257 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-26, Non-Emergency Medical Transportation (NEMT) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 164 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 02-26, Non-Emergency Medical Transportation (NEMT) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 203 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-11, Pregnancy Medical Home | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 35 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-12, Update Of Yearly Levels | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 22 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-15, Non-Emergency Medical Transportation | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 58 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-18, Health Coverage For Workers With Disabilities (HCWD) Premiums | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 25 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-18, Revision And Relocation Of Policy: Estate Recovery, Pregnant Woman Coverage, Auto Newborn & Community Alternatives Program (CAP) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 15 MB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-19, Alliant Health Solutions | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 114 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-19, Family And Children’s Medicaid Table Of Contents And Twelve Months Transitional Medicaid | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 162 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-20, Community Alternative Program (CAP) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 133 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-20, Community Alternative Program (CAP) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 238 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-21, Disability | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 271 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-21, Reasonable Compatibility | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 365 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-22, Money Follows The Person | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 336 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-22, Pregnant Woman Coverage | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 234 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-23, 2023 Federal Poverty Level (FPL) Changes and the Removal of MA-3255, North Carolina Health Choice (NCHC) Policy | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 256 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-23, Recertification | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 285 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-24, MA-2352, Change In Circumstance, Terminations, And Reopening | Adult Medicaid | Change Notice | pdf | 259 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-24, Notice and Hearings Process | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 356 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-25, 2025 Federal Poverty Level Changes (FPL) Income Changes | Adult Medicaid | Change Notice | pdf | 365 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-25, MA-3345 AGE/NAME/MARITAL STATUS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 373 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-26, 2026 Federal Poverty Level (FPL) Income Changes | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 147 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 03-26, 2026 Federal Poverty Level Changes (FPL) Income Changes and Cost of Living Adjustment (COLA) Disregard | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 132 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-05, County Transfers | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 22 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-13, Medicaid Suspension For Incarcerated Beneficiaries | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 82 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-15, Non-Emergency Medical Transportation | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 57 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-17, Special Needs Trust | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 13 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-18, Transfer Of Assets, Home Equity Value And Low-Income Subsidy Limits/Resources | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 115 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-19, 2019 Federal Poverty Level Changes (FPL) And Health Coverage For Workers With Disabilities | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 127 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-19, Alliant Health Solutions | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 172 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-20, Living Arrangement – Amended | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 284 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-20, Living Arrangement – Amended | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 296 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-21, Beneficiary Fraud and Abuse Policy and Procedures | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 258 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-22, Non-Emergency Medical Transportation (NEMT) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 351 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-22, Traumatic Brain Injury (TBI) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 140 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-23, Medically Needy Recertification | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 443 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-23, Medically Needy Recertification | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 708 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-24, 2024 Federal Poverty Level (FPL) Income Changes | Family and Children's Medicaid | Change Notice | pdf | 254 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-24, MA-2420, Notice And Hearings Process | Adult Medicaid | Change Notice | pdf | 257 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-25, Medicaid For Former Foster Care Children | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 174 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-25, 2025 Maximum Community Spouse Income Allowance | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 166 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-26, Non-Emergency Medical Transportation (NEMT) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 111 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 04-26, Non-Emergency Medical Transportation (NEMT) | Family and Children's Medicaid | Change Notice | pdf | 149 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-17, Disability | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 95 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-18, Changes Related To 2019 Cost-Of-Living Adjustment (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 9 MB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-19, Notice and Hearings Process | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 212 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-20, Tribal Membership and American Indian Health Service | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 273 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-21, 2021 Federal Poverty Level Changes and Low Income Subsidy (LIS) Income Limits | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 227 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-22, Non-Emergency Medical Transportation (NEMT) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 249 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-23, Change in Circumstance, Terminations, and Reopening | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 372 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-24, 2024 Federal Poverty Level (FPL) Income Changes | Adult Medicaid | Change Notice | pdf | 170 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-25, MA-2500 AGE/NAME/MARITAL STATUS | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 275 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 05-26, Health Coverage For Workers With Disabilities (HCWD) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 189 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-10, Citizen/Alien Requirements | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 69 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-18, Evaluating Local Agency/ DDS Performances, Application Processing-Corrective Action Procedures, Modified Adjusted Gross Income (MAGI), & Transitional Medicaid (TMA) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 557 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-18, Qualified Medicare Beneficiaries (MQB-Q, MQB-B & MQB-E), Community Alternatives Program (CAP) And Estate Recovery | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 12 MB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-19, Notice and Hearings Process, and Twelve Month Transitional Medicaid | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 217 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-20, Tribal Membership and American Indian Health Service | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 371 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-21, Beneficiary Fraud and Abuse Policy and Procedures | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 278 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-22, Disability | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 427 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-23, 2023 Pickle Amendment | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 141 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-23, Change of Circumstance, Terminations, and Reopening | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 191 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-24, 2024 Low Income Subsidy (LIS) Income Limits, DHB-5179 And Basic Medicaid Eligibility Requirements | Adult Medicaid | Change Notice | pdf | 243 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-24, Reasonable Opportunity Period | Family and Children's Medicaid | Change Notice | pdf | 372 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-25, MA-2110 Pass-along | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 282 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 06-25, MA-3205 Post-eligibility Verification | Family and Children's Medicaid | Change Notice | pdf | 270 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-04, Certification & Authorization | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 16 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-10, IV-D Sanctions For Non-Cooperation | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 24 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-11, 2011 Medicare Deductible, Co-Insurance, Medicaid ICF/MR, Hospice Rates | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 31 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-13, Certification Periods | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 17 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-15, Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 12 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-18, Notice And Hearings Process | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 159 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-19, Breast And Cervical Cancer Medicaid (BCCM) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 64 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-21, Program of All-Inclusive Care for the Elderly (PACE) – Amended | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 73 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-21, Program of All-Inclusive Care for the Elderly (PACE) Amended | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 62 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-22, Changes Related To 2023 Cost-Of-Living Adjustment (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 370 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-23, Reasonable Compatibility | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 242 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-23, Traumatic Brain Injury | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 166 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-24, Changes Related To 2025 Cost-Of-Living Adjustment (COLA) | Family and Children's Medicaid | Change Notice | pdf | 267 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-24, Health Coverage For Workers With Disabilities | Adult Medicaid | Change Notice | pdf | 153 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-25, CHANGES RELATED TO 2026 COST-OF-LIVING ADJUSTMENT (COLA) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 153 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 07-25, MA- 2301 Post-eligibility Verification | Adult Medicaid | Change Notice | pdf | 174 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 08-12, Medicaid Identification Card | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 18 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 08-18, Evaluating Local Agency/ DDS Performances, & Application Processing-Corrective Action Procedures | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 2 MB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 08-21, Alien Requirements | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 266 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 08-21, Alien Requirements | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 320 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 08-23, Estate Recovery | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 177 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 08-23, Estate Recovery | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 259 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 08-25, 2025 Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 489 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-10, Community Alternative Program (CAP) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 23 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-15, Disability Determination Services (DDS) Medicaid Unit Contact Information | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 67 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-18, Notice And Hearings Process | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 99 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-18, Removal Of Policy From The Integrated Manual (IEM) To The Family & Children’s Manual | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 377 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-21, Tribal Membership and American Indian Health Services (IHS) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 136 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-21, Tribal Membership and American Indian Health Services (IHS) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 236 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-23, State Residency | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 253 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-23, State Residency | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 356 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-24, Qualified Medicare Beneficiary (MQB) Reserve Limits | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 177 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 09-25, MA-2110 Pass-along | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 224 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-03, Application Processing | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 68 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-10, Citizen/Alien Requirements | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 66 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-18, Change Notice For Manual No. 10-18, Income | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 29 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-19, Low Income Subsidy Income Limits | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 22 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-21, Family Planning Program | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 258 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-21, Family Planning Program | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 258 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-23, Medicare Enrollment & Buy-In | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 252 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-24, Reasonable Opportunity Period | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 272 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 10-25, MA-2240 Transfer of Assets | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 165 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-10, US Citizenship Requirements/Alien Requirements | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 25 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-18, Inquiry, Discouragement, Application & Outstations | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 246 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-18, Removal Of Policy From The Integrated Manual (IEM) To The Adult Manual | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 99 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-19, Introduction To Medicaid | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 157 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-21, Changes Related To 2022 Cost-Of-Living Adjustment (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 222 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-21, Reasonable Compatibility | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 345 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-23, Security of Internal Revenue Service (IRS) and Social Security Administration (SSA) Data Information | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 190 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-23, Security of Internal Revenue Service (IRS) and Social Security Administration (SSA) Data Information | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 370 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-24, Traumatic Brain Injury | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 157 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 11-25, CHANGES RELATED TO 2026 COST-OF-LIVING ADJUSTMENT (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 117 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-03, Impairment Related Work Expenses & In-Kind Income | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 23 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-05, Medicaid Working Disabled | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 17 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-09, County Residence | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 19 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-18, Removal Of Hospital Presumptive Eligibility And Caretaker Relatives/Kinship From The Integrated Eligibility Manual (IEM) To The Family & Children’s Manual | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 225 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-18, Removal Of Non-Emergency Medical Transportation (NEMT) From The Integrated Eligibility Manual (IEM) To The Adult Manual | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 98 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-21, Reasonable Compatibility | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 245 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-23, Automated Inquiry and Match Procedures | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 175 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-23, Automated Inquiry and Match Procedures | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 176 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 12-24, Changes Related To 2025 Cost-Of-Living Adjustment (COLA) | Adult Medicaid | Change Notice | pdf | 293 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-11, F&C Manual Sections Impacted By Simplification Of Re-Enrollment For MIC/NCHC | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 33 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-12, Veteran Benefit Verification | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 22 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-18, Alien Requirements, Family Planning Program, Post Eligibility Verification & Managed Care | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 233 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-18, Inquiry, Discouragement, Application & Outstations | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 115 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-19, Changes Related To 2020 Cost-Of-Living Adjustment (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 266 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-19, Modified Adjusted Gross Income (MAGI) Countable Income, Non-Countable Income, and Budgeting | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 79 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-21, 2022 Pickle Amendment and Nursing Facility Rates | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 176 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-23, 2024 Change Related to 2024 Cost-of Living Adjustment (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 292 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 13-23, Medicaid Expansion | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 352 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 14-08, Affidavit Of Parentage | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 22 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 14-09, Medicaid Identification Card | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 28 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 14-10, Series # 1 Of Corrections, Additions, Deletions And/Or Updates | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 30 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 14-11, Medicaid Covered Services | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 28 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 14-18, Alien Requirements, Family Planning Program, Post Eligibility Verification & Managed Care | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 103 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 14-23, 2024 Change Related to 2024 Cost-of Living Adjustment (COLA) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 266 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 14-23, Recertification | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 164 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-03, Transfer Of Resources And In-Home Health Services | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 40 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-05, Third Party Recovery | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 25 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-11, Series # 5 Of Corrections, Additions, Deletions And/Or Updates, & Figures/Attachments Removal | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 116 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-12, Emergency Medical Review Contractor Update | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 21 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-19, Community Alternatives Program (CAP) | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 186 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-19, Former Foster Care Program (MFC) and Expanded Foster Care Program (EFCP) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 4 MB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-23, MAGI Adult Medicaid Expansion | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 354 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 15-23, Medically Needy Recertification | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 164 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 16-23, Medically Needy Recertification | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 371 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 17-23, MAGI Recertification | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 363 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 21-06, Medicare Prescription Drug Benefit | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 33 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 22-08, Financial Resources | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 14 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 23-05, SSI Medicaid | Family and Children's Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 29 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 24-07, DRA Transfer Of Assets | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 66 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 24-08, Health Coverage For Workers With Disabilities | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 62 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 24-10, Third Party Resources | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 36 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 25-07, DRA Transfer Of Assets | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 109 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| CHANGE NOTICE FOR MANUAL NO. 28-05, SSI Medicaid – County DSS Responsibility | Adult Medicaid, Health Benefits/NC Medicaid | Change Notice | pdf | 37 KB | | adult-medicaid health-benefits-nc-medicaid | change-notice |
| DHB -DSS 8110 DESK REFERENCE TOOL | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 403 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER 04-24, Extended Period for Ukrainian Immigrants and Parolees | Adult Medicaid | Administrative Letter | pdf | 426 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER 04-25, Returning to Regular Medicaid Policy after the Continuous Coverage Unwinding (CCU) Period Ends | Adult Medicaid, Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 603 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER 08-25, Public Assistance Reporting Information System (PARIS Match) Procedures | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 318 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-19, Extension of Eligibility at Recertification | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 202 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-20, Attachment 1 – DHB Self Attestation – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 222 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-20, Attachment 2 – ZixMail Instructions for State Appeals – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 411 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-20, Medicaid/NCHC Procedures for COVID-19 – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 377 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-20, Medicaid/NCHC Procedures for COVID-19, Addendum 1 – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 333 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-21, Social Security and VA Cost-of-Living Adjustment (Amended) | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 301 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-22, Emergency Rental Assistance (ERA) | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 378 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-23, Changes in Income During Base Period for Modified Adjusted Gross Income (MAGI) Applications and Recertifications | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 389 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-24, CONTINUOUS COVERAGE UNWINDING (CCU) PERIOD AFTER COVID-19 PUBLIC HEALTH EMERGENCY (PHE): MEDICAID PROCEDURES FOR THE e-14/100% INCOME STRATEGY WAIVER | Adult Medicaid, Health Benefits/NC Medicaid | | pdf | 402 KB | | adult-medicaid health-benefits-nc-medicaid | |
| DHB ADMINISTRATIVE LETTER NO: 01-24, Continuous Coverage Unwinding (CCU) Period After Covid-19 Public Health Emergency (PHE): Medicaid Procedures For The E-14/100% Income Strategy Waiver-OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 402 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 01-25, Medicaid Procedures for Asset Verification System (AVS) During the Continuous Coverage Unwinding (CCU) Period-OBSOLETE | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 218 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 02-20, Child Support Guidance Eligibility Verification | Adult Medicaid | Administrative Letter | pdf | 134 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 02-21, NC Health Choice (NCHC) Beneficiary at the Age of 19 Procedures and Reports – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 228 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 02-22, Application Procedures – Authorized Representatives; Social Security Numbers; DMA-5001 Form OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 530 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 02-23, Medicaid Procedures for COVID-19 – Change to Dually Eligible Procedures | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 250 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 02-24, DSS-8110 NOTICE OF MODIFICATION, TERMINATION, OR CONTINUATION OF PUBLIC ASSISTANCE NOTICE PROCEDURES- OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 179 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 03-19, Hawkins V. Cohen Procedure – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 272 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 03-21, AMENDED 2: Medicaid/NCHC Procedures for COVID-19 – Unemployment Income, Stimulus Funds/Transfer of Assets OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 452 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 03-21, AMENDED: Medicaid/NCHC Procedures for COVID-19 – Unemployment Income, Stimulus Funds/Transfer of Assets – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 449 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 03-21, Medicaid/NCHC Procedures for COVID-19 – Unemployment Income, Stimulus Funds/Transfer of Assets Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 441 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 03-22, Hearings and Appeals – Remote Hearings | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 194 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 03-23, Medicaid Procedures for Asset Verification System (AVS) During the Continuous Coverage Unwinding (CCU) Period | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 734 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 04-19, Medicaid Verification Reports | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 68 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 04-20, 2020 Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 275 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 04-21, 2021 Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 276 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 04-22, Automated Notices, DSS-8109 Form | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 458 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 04-23, Medicaid Procedures Using Supplemental Nutrition Assistance Program (SNAP) Income During the Continuous Coverage Unwinding (CCU) Period | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 347 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 04-24, Extended Period for Ukrainian Immigrants and Parolees | Family and Children's Medicaid | Administrative Letter | pdf | 426 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-19, Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 17 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-20, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 555 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-21, AMENDED 2, Medicaid/NCHC Procedures for COVID-19 – Allowable Program Changes and Terminations – OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 271 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-21, AMENDED, Medicaid/NCHC Procedures for COVID-19 – Allowable Program Changes and Terminations (Amended) Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 625 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-21, Medicaid/NCHC Procedures for COVID-19 – Allowable Program Changes and Terminations Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 624 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-22, Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 140 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-23, United States Postal Services (USPS) National Change of Address (NCOA) and United States Postal Services Returned Mail – OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 269 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-24, Emergency Medicaid Procedures for Hurricane Helene – AMENDED- OBSOLETE | Adult Medicaid, Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 671 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-24, Emergency Medicaid Procedures for Hurricane Helene – OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 666 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-24, Emergency Medicaid Procedures for Hurricane Helene – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 666 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 05-25, Continuous Eligibility For Children | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 386 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-19, ADDENDUM 1, Medicaid Procedures for Hurricane Dorian | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 228 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-19, ADDENDUM 1, Medicaid Procedures for Hurricane Dorian – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 228 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-20, Attachment – DHB Self-Attestation | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 240 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-20, Medicaid/NCHC Procedures for COVID-19, Self- Attestation and Reports OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 348 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-21, AMENDED, Medicaid Procedures for COVID-19 – Increasing PMLS (Amended) OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 465 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-21, Medicaid Procedures for COVID-19 – Increasing PMLS OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 466 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-23, Continuous Coverage Unwinding (CCU) Period after COVID-19 Public Health Emergency (PHE): Medicaid Procedures – Amended Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 567 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-23, Continuous Coverage Unwinding (CCU) Period after COVID-19 Public Health Emergency (PHE): Medicaid Procedures – Amended 2 – OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 468 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-23, Continuous Coverage Unwinding (CCU) Period after COVID-19 Public Health Emergency (PHE): Medicaid Procedures – Amended Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 567 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-23, Continuous Coverage Unwinding (CCU) Period after COVID-19 Public Health Emergency (PHE): Medicaid Procedures Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 537 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-23, Self-Attestation Attachment-OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 346 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 06-23, Self-Attestation Attachment-OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 346 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-20, Attachment – ZixMail Instructions for State Appeals | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 428 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-20, Medicaid/NCHC Procedures for COVID-19 – Amended 2 OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 309 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-20, Medicaid/NCHC Procedures for COVID-19 – Amended Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 333 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-21, AMENDED 2, Medicaid/NC Health Choice Application/Recertification/Change of Circumstance Procedures for COVID-19 – Amended 2 OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 679 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-21, AMENDED, Medicaid/NC Health Choice Application/Recertification/Change of Circumstance Procedures for COVID-19 OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 675 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-21, Attachment: NC FAST Batch Exclusion Template | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | xlsx | 16 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-21, Medicaid/NC Health Choice Recertification Procedures for COVID-19 Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 603 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-22, Ukrainian Immigrants and Parolees – Amended 2 OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 242 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-22, Ukrainian Immigrants and Parolees – Amended 3 | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 500 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-22, Ukrainian Immigrants and Parolees OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 376 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-22, Ukrainian Immigrants and Parolees- Amended OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 478 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-23, Medicaid for COVID-19 Testing Group – Applications | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 344 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-24, Hurricane Helene – Guidance for Unemployment Insurance Benefits (UIB) | Adult Medicaid, Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 305 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 07-25, Victims of Human Trafficking T-Visa Clarifications | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 244 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 08-20, Procedures for MAGI Deductions | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 244 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 08-21, Afghan Special Immigrants and Parolees | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 381 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 08-22, Application Procedures for Authorized Representatives and Complete/Incomplete Applications – Amended | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 715 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 08-22, Application Procedures for Authorized Representatives and Complete/Incomplete Applications OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 563 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 08-23, 2023 Spousal Impoverishment | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 144 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 09-20, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Amended – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 617 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 09-20, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Amended 2 -Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 384 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 09-20, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Obsolete | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 532 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 09-21, Deferred Enforced Departure for Hong Kong Residents | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 263 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 09-22, Modified Adjusted Gross Income (MAGI) Recertification Procedures and Voice Signature | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 457 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 09-23, Retroactive and Ongoing Dually Eligible Applicants/Beneficiaries – Medical Expenses | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 472 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 10-20, Extended Limits of Confinement for Inmate Release Procedures for COVID-19 OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 343 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 10-21, Social Security and VA Cost-of-Living Adjustment | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 280 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 10-22, North Carolina Health Choice (NCHC) Pregnant Applicants/Beneficiaries Who Report Pregnancy | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 137 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 10-23, Health Coverage for Workers with Disabilities – Updated Procedures | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 491 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 10-25, Updated Guidance For The Dss-8110 Desk Reference Tool | Adult Medicaid, Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 184 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 11-20, Medicaid COVID-19 Optional Testing Group – OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 291 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 11-22, 2023 Social Security And VA Cost-Of-Living Adjustment (COLA) | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 254 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 11-23, Request for NC Innovations Waiver Action Indicator Action Needed | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 309 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 12-20, Program of All-Inclusive Care for the Elderly (PACE)Voluntary/Involuntary Disenrollment | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 243 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 12-22, Prepaid Health Plan (PHP) Notification Of Nursing Facility Level Of Care Form | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 180 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 12-23, Medicaid Procedures for Requesting Corrections – DSS Support Unit | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 567 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 13-23, Child Support Cooperation and Applying for Other Monetary Benefits Post Eligibility During the Continuous Coverage Unwinding (CCU) Period – OBSOLETE | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 314 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO: 14-23, DHB-2187, Notice Of Potential Change in Medicaid Eligibility/ Breast and Cervical Cancer Medicaid (BCCM) And Family & Children’s Medically Needy/Medical Forced Eligibility (MAF/MFE) | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 220 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO:01-26, Continuous Eligibility for Children | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 230 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO:02-25, Living Arrangement And Medicaid Suspension/Termination For Incarcerated Beneficiaries | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 549 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO:03-25, Medicaid Recertification Procedures | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 188 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO:06-25, 2025 Spousal Impoverishment Standards | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 168 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO:09-25, Social Security Number Verification Procedures For Auto-Newborns | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 242 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-20, ADDENDUM 1, Medicaid/NCHC Procedures for COVID-19 – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 357 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-20, Attachment 1 -DHB Self Attestation – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 222 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-20, Attachment 2 – ZixMail Instructions for State Appeals – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 411 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-20, Medicaid/NCHC Procedures for COVID-19 – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 377 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-21, AMENDED, Social Security and VA Cost-of-Living Adjustment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 301 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-22, Emergency Rental Assistance (ERA) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 378 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-23, Changes in Income During Base Period for Modified Adjusted Gross Income (MAGI) Applications and Recertifications | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 389 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 01-24, CONTINUOUS COVERAGE UNWINDING (CCU) PERIOD AFTER COVID-19 PUBLIC HEALTH EMERGENCY (PHE): MEDICAID PROCEDURES FOR THE e-14/100% INCOME STRATEGY WAIVER-OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 402 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 02-20, Child Support Guidance Eligibility Verification | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 134 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 02-22, Application Procedures – Authorized Representatives; Social Security Numbers; DMA-5001 Form Obsolete – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 530 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 02-23, Medicaid Procedures for COVID-19 – Change to Dually Eligible Procedures | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 250 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 02-24, DSS-8110 NOTICE OF MODIFICATION, TERMINATION, OR CONTINUATION OF PUBLIC ASSISTANCE NOTICE PROCEDURES- OBSOLETE | Family and Children's Medicaid | Administrative Letter | pdf | 189 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 03-21, AMENDED 2, Medicaid/NCHC Procedures for COVID-19 – Unemployment Income, Stimulus Funds/Transfer of Assets – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 452 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 03-21, AMENDED, Medicaid/NCHC Procedures for COVID-19 – Unemployment Income, Stimulus Funds/Transfer of Assets – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 449 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 03-21, Medicaid/NCHC Procedures for COVID-19 – Unemployment Income, Stimulus Funds/Transfer of Assets – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 441 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 03-22, Hearings and Appeals – Remote Hearings | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 194 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 03-23, Medicaid Procedures for Asset Verification System (AVS) During the Continuous Coverage Unwinding (CCU) Period | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 734 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 04-20, 2020 Spousal Impoverishment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 275 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 04-21, 2021 Spousal Impoverishment Standards | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 276 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 04-22, Automated Notices, DSS-8109 Form | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 458 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 04-23, Medicaid Procedures Using Supplemental Nutrition Assistance Program (SNAP) Income During the Continuous Coverage Unwinding (CCU) Period- OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 347 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 05-20, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 555 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 05-21, AMENDED, Medicaid/NCHC Procedures for COVID-19 – Allowable Program Changes and Terminations – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 625 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 05-21, Medicaid/NCHC Procedures for COVID-19 – Allowable Program Changes and Terminations – Amended 2 OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 271 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 05-21, Medicaid/NCHC Procedures for COVID-19 – Allowable Program Changes and Terminations – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 624 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 05-22, 2022 Spousal Impoverishment Standards | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 140 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 05-23, United States Postal Services (USPS) National Change of Address (NCOA) and United States Postal Services Returned Mail-OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 269 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 05-24, EMERGENCY MEDICAID PROCEDURES FOR HURRICANE HELENE- AMENDED 2 | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 669 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-20, Medicaid/NC Health Choice Procedures for COVID-19 , Self-Attestation and Reports – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 348 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-20, Medicaid/NCHC Procedures for COVID-19, Self-Attestation for Eligibility Criteria | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 240 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-21, AMENDED, Medicaid Procedures for COVID-19 – Increasing PMLS (Amended) OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 465 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-21, Medicaid Procedures for COVID-19 – Increasing PMLS OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 466 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-23, AMENDED 2, Continuous Coverage Unwinding (CCU) Period After COVID-19 Public Health Emergency (PHE): Medicaid Procedures-OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 468 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-23, AMENDED, Continuous Coverage Unwinding (CCU) Period after COVID-19 Public Health Emergency (PHE): Medicaid Procedures – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 567 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-23, Continuous Coverage Unwinding (CCU) Period after COVID-19 Public Health Emergency (PHE): Medicaid Procedures – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 279 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-23, Self-Attestation Attachment – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 346 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-23, Self-Attestation Attachment-OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 346 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 06-24, HURRICANE HELENE- GUIDANCE FOR MEDICAID APPLICATIONS IN DISASTER COUNTIES- AMENDED 2 | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 514 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-20, AMENDED 2, Medicaid/NC Health Choice Procedures for COVID-19 – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 309 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-20, AMENDED, Medicaid/NC Health Choice Procedures for COVID-19 – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 333 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-20, Attachment – ZixMail Instructions for State Appeals | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 428 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-21, AMENDED 2, Medicaid/NC Health Choice Application/Recertification/Change of Circumstance Procedures for COVID-19 – Amended 2 OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 679 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-21, AMENDED, Medicaid/NC Health Choice Application/Recertification/Change of Circumstance Procedures for COVID-19 – Amended OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 675 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-21, Attachment: NC FAST COVID Batch Exclusion Template | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | xlsx | 16 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-21, Medicaid/NC Health Choice Recertification Procedures for COVID-19 Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 603 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-22, AMENDED 2, Ukrainian Immigrants and Parolees – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 242 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-22, AMENDED 3, Ukrainian Immigrants and Parolees | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 500 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-22, AMENDED, Ukrainian Immigrants and Parolees – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 478 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-22, Ukrainian Immigrants and Parolee – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 376 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 07-23, Medicaid for COVID-19 Testing Group – Applications | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 344 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 08-20, Procedures for MAGI Deductions | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 244 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 08-21, Afghan Special Immigrants and Parolees | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 381 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 08-22, AMENDED, Application Procedures for Authorized Representatives and Complete/Incomplete Applications | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 715 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 08-22, Application Procedures for Authorized Representatives and Complete/Incomplete Applications – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 563 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 08-23, 2023 Spousal Impoverishment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 144 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 09-20, AMENDED 2, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 384 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 09-20, AMENDED, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 617 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 09-20, Medicaid/NC Health Choice Recertification Procedures for COVID-19 – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 532 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 09-21, Deferred Enforced Departure for Hong Kong Residents | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 263 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 09-22, Modified Adjusted Gross Income (MAGI) Recertification Procedures and Voice Signature | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 457 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 09-23, Retroactive and Ongoing Dually Eligible Applicants/Beneficiaries – Medical Expenses | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 472 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 10-20, Extended Limits of Confinement Inmate Release Procedures for COVID-19 OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 343 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 10-21, Social Security and VA Cost-of-Living Adjustment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 280 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 10-22, North Carolina Health Choice (NCHC) Pregnant Applicants/Beneficiaries Who Report Pregnancy | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 137 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 10-23, Health Coverage for Workers with Disabilities – Updated Procedures | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 491 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 11-20, Medicaid COVID-19 Optional Testing Group – OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 291 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 11-22, 2023 Social Security And VA Cost-Of-Living Adjustment (COLA) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 254 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 11-23, Request for NC Innovations Waiver Action Indicator Action Needed | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 309 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 12-20, Program of All-Inclusive Care For The Elderly (PACE)Voluntary/Involuntary Disenrollment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 243 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 12-22, Prepaid Health Plan (PHP) Notification of Nursing Facility Level Of Care Form | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 180 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 12-23, Medicaid Procedures for Requesting Corrections – DSS Support Unit | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 567 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 13-23, Child Support Cooperation and Applying for Other Monetary Benefits Post Eligibility During the Continuous Coverage Unwinding (CCU) Period-OBSOLETE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 314 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINISTRATIVE LETTER NO. 14-23, DHB-2187, Notice of Potential Change in Medicaid Eligibility/ Breast and Cervical Cancer Medicaid (BCCM) and Family & Children’s Medically Needy/Medical Forced Eligibility (MAF/MFE) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 220 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINSTRATIVE LETTER NO: 03-24, 2024 Spousal Impoverishment Standards | Adult Medicaid, Family and Children's Medicaid | Administrative Letter | pdf | 158 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINSTRATIVE LETTER NO: 06-24, Hurricane Helene – Guidance for Medicaid Applications in Disaster Counties – OBSOLETE | Adult Medicaid, Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 241 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB ADMINSTRATIVE LETTER NO: 06-24, Hurricane Helene – Guidance for Medicaid Applications in Disaster Counties – AMENDED- OBSOLETE | Adult Medicaid, Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 243 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DHB-1061 Checklist for Child Medical Evaluation (CME) Reporting | Health Benefits/NC Medicaid | Form | pdf | 291 KB | | health-benefits-nc-medicaid | form |
| DHB-2039 PHP Notification of Nursing Facility Level of Care | Health Benefits/NC Medicaid | Form | pdf | 239 KB | | health-benefits-nc-medicaid | form |
| DHB-2040 Tribal and Indian Health Services | Health Benefits/NC Medicaid | Form | pdf | 155 KB | | health-benefits-nc-medicaid | form |
| DHB-2040B Tribal and Indian Health Services | Health Benefits/NC Medicaid | Form | pdf | 189 KB | | health-benefits-nc-medicaid | form |
| DHB-2043 Third Party Recovery Accident Information Form | Health Benefits/NC Medicaid | Form | pdf | 797 KB | | health-benefits-nc-medicaid | form |
| DHB-2044ia Medicaid Credit Balance Report | Health Benefits/NC Medicaid | Form | pdf | 189 KB | | health-benefits-nc-medicaid | form |
| DHB-2045 Instructions for Completing Medicaid Credit Balance Report | Health Benefits/NC Medicaid | Form | pdf | 141 KB | | health-benefits-nc-medicaid | form |
| DHB-2050 Voluntary Request to Terminate Medicaid | Health Benefits/NC Medicaid | Form | pdf | 114 KB | | health-benefits-nc-medicaid | form |
| DHB-2050esp-ia SOLICITUD VOLUNTARIA PARA FINALIZAR MEDICAID | Adult Medicaid, Family and Children's Medicaid, Health Benefits/NC Medicaid | Form | pdf | 18 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | form |
| DHB-2055 Reimbursement for Medical Transportation | Health Benefits/NC Medicaid | Form | xls | 34 KB | | health-benefits-nc-medicaid | form |
| DHB-2056 Purchased Medical Transportation Costs | Health Benefits/NC Medicaid | Form | xls | 83 KB | | health-benefits-nc-medicaid | form |
| DHB-2060 Request To Leave Transitions To Community Living (TCL) | Health Benefits/NC Medicaid | Form | pdf | 144 KB | | health-benefits-nc-medicaid | form |
| DHB-2190 Internal Inspection Report | Health Benefits/NC Medicaid | Form | pdf | 483 KB | | health-benefits-nc-medicaid | form |
| DHB-2191 Designation of Control Officer for FRR/Beer Reports | Health Benefits/NC Medicaid | Form | pdf | 217 KB | | health-benefits-nc-medicaid | form |
| DHB-2192 SSA Training Form – County Staff and County Contract Staff | Health Benefits/NC Medicaid | Form | pdf | 95 KB | | health-benefits-nc-medicaid | form |
| DHB-2193 Memorandum of CAP Waiver Enrollment | Health Benefits/NC Medicaid | Form | pdf | 253 KB | | health-benefits-nc-medicaid | form |
| DHB-2194 IRC Rules Handout | Health Benefits/NC Medicaid | Form | pdf | 139 KB | | health-benefits-nc-medicaid | form |
| DHB-2195 Documentation of Annual Security Training Confidentiality Form – County Staff | Health Benefits/NC Medicaid | Form | pdf | 102 KB | | health-benefits-nc-medicaid | form |
| DHB-2196 Documentation of Annual Security Training – Shred Contractor Training | Health Benefits/NC Medicaid | Form | pdf | 103 KB | | health-benefits-nc-medicaid | form |
| DHB-2197 FTI Record Keeping Log | Health Benefits/NC Medicaid | Form | xls | 30 KB | | health-benefits-nc-medicaid | form |
| DHB-2198 Log for Destruction of the FRR/BEER Reports | Health Benefits/NC Medicaid | Form | pdf | 80 KB | | health-benefits-nc-medicaid | form |
| DHB-2199 Documentation of the Visitation Logs | Health Benefits/NC Medicaid | Form | pdf | 45 KB | | health-benefits-nc-medicaid | form |
| DHB-2200 Access Control Log | Health Benefits/NC Medicaid | Form | pdf | 45 KB | | health-benefits-nc-medicaid | form |
| DHB-2201 Confidentiality of Safeguard Data | Health Benefits/NC Medicaid | Form | pdf | 140 KB | | health-benefits-nc-medicaid | form |
| DHB-2202 Beneficiary Notice | Health Benefits/NC Medicaid | Form | pdf | 79 KB | | health-benefits-nc-medicaid | form |
| DHB-4037 Disability Determination Transmittal | Health Benefits/NC Medicaid | Form | pdf | 165 KB | | health-benefits-nc-medicaid | form |
| DHB-5001N FRENCH AVIS SUR L’UTILISATION DES NUMÉROS DE SÉCURITÉ SOCIALE | Adult Medicaid, Family and Children's Medicaid | Form | pdf | 97 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | form |
| DHB-5001N Notice on the Use of Social Security Numbers | Health Benefits/NC Medicaid | Form | pdf | 107 KB | | health-benefits-nc-medicaid | form |
| DHB-5001N_sp AVISO SOBRE EL USO DE LOS N√öMEROS DE SEGURO SOCIAL | Health Benefits/NC Medicaid | Form | pdf | 186 KB | | health-benefits-nc-medicaid | form |
| DHB-5002 Important Notice About Your Medicaid or Special Assistance Approval | Health Benefits/NC Medicaid | Form | pdf | 768 KB | | health-benefits-nc-medicaid | form |
| DHB-5002 Lao ກະລຸນາອ່ານແຈ້ງການສໍ າຄັ ນນີ້ກ່ຽວກັ ບແຈ້ງການການອະນຸມັ ດ MEDICAID ຫືຼ ຄວາມຊ່ວຍເຫື ອພິ ເສດຂອງທ ຼ ່ານ | Health Benefits/NC Medicaid | Form | pdf | 201 KB | | health-benefits-nc-medicaid | form |
| DHB-5002sp-ia Lea Este Importante Aviso Sobre Medicail o la Asistencia Especial Aviso de Aprobacion | Health Benefits/NC Medicaid | Form | pdf | 296 KB | | health-benefits-nc-medicaid | form |
| DHB-5003 French VEUILLEZ LIRE CET AVIS IMPORTANT CONCERNANT VOTRE AVIS D’APPROBATION POUR MEDICAID | Health Benefits/NC Medicaid | Form | pdf | 203 KB | | health-benefits-nc-medicaid | form |
| DHB-5003 Hmong THOV NYEEM DAIM NTAWV CEEB TOOM UAS TSEEM CEEB NO HAIS TXOG KOJ DAIM NTAWV CEEB TOOM KEV TSO CAI NTAWM MEDICAID | Health Benefits/NC Medicaid | Form | pdf | 192 KB | | health-benefits-nc-medicaid | form |
| DHB-5003 Korean 귀하의 MEDICAID 승인 통지서와 관련된 본 중요 공지사항을 읽어주십시오 | Health Benefits/NC Medicaid | Form | pdf | 249 KB | | health-benefits-nc-medicaid | form |
| DHB-5003 Medicaid Approval Notice | Health Benefits/NC Medicaid | Form | pdf | 349 KB | | health-benefits-nc-medicaid | form |
| DHB-5003 Vietnamese VUI LÒNG ĐỌC THÔNG BÁO QUAN TRỌNG NÀY LIÊN QUAN ĐẾN THÔNG BÁO PHÊ DUYỆT MEDICAID CỦA QUÝ VỊ | Health Benefits/NC Medicaid | Form | pdf | 162 KB | | health-benefits-nc-medicaid | form |
| DHB-5003-ia RUSSIAN ОЗНАКОМЬТЕСЬ С ЭТИМ ВАЖНЫМ УВЕДОМЛЕНИЕМ ОБ ИЗВЕЩЕНИИ О ПОДТВЕРЖДЕНИИ ПРОГРАММЫ MEDICAID | Adult Medicaid, Family and Children's Medicaid | Form | pdf | 266 KB | | adult-medicaid family-and-childrens-medicaid health-benefits-nc-medicaid | form |
| DHB-5003sp-ia LEA ESTE IMPORTANTE AVISO SOBRE MEDICAID AVISO DE APROBACION | Health Benefits/NC Medicaid | Form | pdf | 134 KB | | health-benefits-nc-medicaid | form |
| DHB-5004-ia Buy-In Clerical Action | Health Benefits/NC Medicaid | Form | pdf | 201 KB | | health-benefits-nc-medicaid | form |
| DHB-5008a Adult Budget Sheet | Health Benefits/NC Medicaid | Form | pdf | 183 KB | | health-benefits-nc-medicaid | form |
| DHB-5008a Adult Budget Sheet | Health Benefits/NC Medicaid | | pdf | 183 KB | | health-benefits-nc-medicaid | |
| DHB-5008B Supplement B | Health Benefits/NC Medicaid | Form | pdf | 229 KB | | health-benefits-nc-medicaid | form |
| DHB-5008c-ia Spouse and Dependent Income Allowance Worksheet | Health Benefits/NC Medicaid | Form | pdf | 189 KB | | health-benefits-nc-medicaid | form |
| DHB-5008e ABD Medicaid Parent To Child Deeming Budgeting Sheet | Health Benefits/NC Medicaid | Form | pdf | 221 KB | | health-benefits-nc-medicaid | form |
| DHB-5009 Social History Summary For The Disabled | Health Benefits/NC Medicaid | Form | pdf | 146 KB | | health-benefits-nc-medicaid | form |
| DHB-5009esp-ia RESUMEN DE HISTORIA SOCIAL PARA PERSONAS CON DISCAPACIDADES | Health Benefits/NC Medicaid | Form | pdf | 48 KB | | health-benefits-nc-medicaid | form |
| DHB-5016-ia Notification of Eligibility for Medicaid/Amount and Effective Date of Patient’s Liability | Health Benefits/NC Medicaid | Form | pdf | 140 KB | | health-benefits-nc-medicaid | form |
| DHB-5024 Transportation Assessment Notification | Health Benefits/NC Medicaid | Form | pdf | 139 KB | | health-benefits-nc-medicaid | form |
| DHB-5024sp Aviso de Evaluación de Transporte | Health Benefits/NC Medicaid | Form | pdf | 103 KB | | health-benefits-nc-medicaid | form |
| DHB-5026 Notice Of Obligation To Apply For Veteran’s Benefits | Health Benefits/NC Medicaid | Form | pdf | 105 KB | | health-benefits-nc-medicaid | form |
| DHB-5027 Veteran’s Benefits Verification Letter | Health Benefits/NC Medicaid | Form | pdf | 141 KB | | health-benefits-nc-medicaid | form |
| DHB-5028-ia Authorization to Disclose Information | Health Benefits/NC Medicaid | Form | pdf | 259 KB | | health-benefits-nc-medicaid | form |
| DHB-5028esp-ia AUTORIZACION PARA COMPARTIR INFORMACION | Health Benefits/NC Medicaid | Form | pdf | 249 KB | | health-benefits-nc-medicaid | form |
| DHB-5036 Record Of Medical Expenses Applied To The Deductible | Health Benefits/NC Medicaid | Form | pdf | 218 KB | | health-benefits-nc-medicaid | form |
| DHB-5043 Verification Form For Self-Employment Income and Expenses | Health Benefits/NC Medicaid | Form | pdf | 143 KB | | health-benefits-nc-medicaid | form |
| DHB-5043-ia FORMULARIO DE VERIFICACIÓN DE INGRESOS Y GASTOS DE TRABAJO POR CUENTA PROPIA | Health Benefits/NC Medicaid | Form | pdf | 175 KB | | health-benefits-nc-medicaid | form |
| DHB-5043-ia Verification Form For Self-Employment Income and Expenses | Health Benefits/NC Medicaid | Form | pdf | 79 KB | | health-benefits-nc-medicaid | form |
| DHB-5046 Notice of Rights/Responsibilities – Medical Transportation Assistance (English & Spanish) | Health Benefits/NC Medicaid | Form | pdf | 143 KB | | health-benefits-nc-medicaid | form |
| DHB-5046 French AIDE AU TRANSPORT MÉDICAL EN CAROLINE DU NORD (NC) AVIS RELATIF AUX DROITS/RESPONSABILITÉS | Health Benefits/NC Medicaid | Form | pdf | 140 KB | | health-benefits-nc-medicaid | form |
| DHB-5046 Russian УВЕДОМЛЕНИЕ О ПРАВАХ/ОБЯЗАННОСТЯХ | Health Benefits/NC Medicaid | Form | pdf | 137 KB | | health-benefits-nc-medicaid | form |
| DHB-5046_Vietnamese HỖ TRỢ VẬN CHUYỂN Y TẾ NC THÔNG BÁO VỀ QUYỀNTRÁCH NHIỆM | Health Benefits/NC Medicaid | Form | pdf | 163 KB | | health-benefits-nc-medicaid | form |
| DHB-5047 Medicaid Transportation Assessment | Health Benefits/NC Medicaid | Form | pdf | 323 KB | | health-benefits-nc-medicaid | form |
| DHB-5048 Medicaid Transportation Exception Verification | Health Benefits/NC Medicaid | Form | pdf | 326 KB | | health-benefits-nc-medicaid | form |
| DHB-5049-ia Referral to Local Social Security Office | Health Benefits/NC Medicaid | Form | pdf | 591 KB | | health-benefits-nc-medicaid | form |
| DHB-5051 Estate Subject To Medicaid Recovery: Individuals Under Age 55 | Health Benefits/NC Medicaid | Form | pdf | 238 KB | | health-benefits-nc-medicaid | form |
| DHB-5051sp Notice of Medicaid Recovery – People Under 55 (Spanish) | Health Benefits/NC Medicaid | Form | pdf | 238 KB | | health-benefits-nc-medicaid | form |
| DHB-5052 NOTICE: YOUR ESTATE IS SUBJECT TO MEDICAID RECOVERY | Health Benefits/NC Medicaid | Form | pdf | 245 KB | | health-benefits-nc-medicaid | form |
| DHB-5052 sp AVISO IMPORTANTE SU PATRIMONIO ESTÁ SUJETO A RECUPERACIÓN DE MEDICAID | Health Benefits/NC Medicaid | Form | pdf | 251 KB | | health-benefits-nc-medicaid | form |
| DHB-5052sa State/County Special Assistance Beneficiary Estate Subject to Medicaid Recovery Notice | Health Benefits/NC Medicaid | Form | pdf | 150 KB | | health-benefits-nc-medicaid | form |
| DHB-5052SA-sp Notificación al Beneficiario de la Asistencia Especial Del Estado/Condado Sobre la Recuperación de los Gasto Médicos Pagados por Medicaid | Health Benefits/NC Medicaid | Form | pdf | 207 KB | | health-benefits-nc-medicaid | form |
| DHB-5053 Estate Recovery – Permanently Institutionalized | Health Benefits/NC Medicaid | Form | pdf | 151 KB | | health-benefits-nc-medicaid | form |
| DHB-5053sp SU PATRIMONIO ESTÁ SUJETO A RECUPERACIÓN DE MEDICAID | Health Benefits/NC Medicaid | Form | pdf | 146 KB | | health-benefits-nc-medicaid | form |
| DHB-5054 Estate Recovery – Claim Notice | Health Benefits/NC Medicaid | Form | pdf | 165 KB | | health-benefits-nc-medicaid | form |
| DHB-5054sp – Estate Recovery – Claim Notice (Spanish) | Health Benefits/NC Medicaid | Form | pdf | 139 KB | | health-benefits-nc-medicaid | form |
| DHB-5056 Estate Recovery Information Form | Health Benefits/NC Medicaid | Form | pdf | 117 KB | | health-benefits-nc-medicaid | form |
| DHB-5076 Pregnancy Management Program | Health Benefits/NC Medicaid | Form | pdf | 76 KB | | health-benefits-nc-medicaid | form |
| DHB-5076 Pregnancy Management Program -Spanish Version | Health Benefits/NC Medicaid | Form | pdf | 82 KB | | health-benefits-nc-medicaid | form |
| DHB-5078 Medicaid Transportation Monitoring Report | Health Benefits/NC Medicaid | Form | pdf | 123 KB | | health-benefits-nc-medicaid | form |
| DHB-5079 Breast and Cervical Cancer Medicaid Application | Health Benefits/NC Medicaid | Form | pdf | 385 KB | | health-benefits-nc-medicaid | form |
| dhb-5079sp Solicitud de Medicaid para c√°ncer de seno y de cuello uterino | Health Benefits/NC Medicaid | Form | pdf | 377 KB | | health-benefits-nc-medicaid | form |
| dhb-5081-ia Breast and Cervical Cancer Verification: Screening, Diagnosis and Treatment | Health Benefits/NC Medicaid | Form | pdf | 199 KB | | health-benefits-nc-medicaid | form |
| dhb-5081r-ia Breast and Cervical Cancer Recertification: Screening, Diagnosis and Treatment | Health Benefits/NC Medicaid | Form | pdf | 150 KB | | health-benefits-nc-medicaid | form |
| dhb-5081r-sp-ia Para Seguir Recibiendo Cobertura De Medicaid Para El Cancer De Seno Y El Cancer Del Cuello Uterino | Health Benefits/NC Medicaid | Form | pdf | 146 KB | | health-benefits-nc-medicaid | form |
| dhb-5081sp-ia Verificacion De Evaluacion, Diagnostico Y Tratamiento | Health Benefits/NC Medicaid | Form | pdf | 147 KB | | health-benefits-nc-medicaid | form |
| dhb-5082 Transitional Benefit Report | Health Benefits/NC Medicaid | Form | pdf | 185 KB | | health-benefits-nc-medicaid | form |
| DHB-5082sp INFORME SOBRE BENEFICIOS DE TRANSICIÓN | Health Benefits/NC Medicaid | Form | pdf | 163 KB | | health-benefits-nc-medicaid | form |
| dhb-5083 Notice of Transitional Benefits | Health Benefits/NC Medicaid | Form | pdf | 199 KB | | health-benefits-nc-medicaid | form |
| dhb-5083sp Aviso De Beneficios Transitorios | Health Benefits/NC Medicaid | Form | pdf | 206 KB | | health-benefits-nc-medicaid | form |
| dhb-5084 Transitional Benefits Good Cause | Health Benefits/NC Medicaid | Form | pdf | 149 KB | | health-benefits-nc-medicaid | form |
| dhb-5084sp Motivos Justificados Para No Haber Entregado A Tiempo Su Informe De Beneficios Transitorios | Health Benefits/NC Medicaid | Form | pdf | 136 KB | | health-benefits-nc-medicaid | form |
| dhb-5087-ia Check List For Breast and Cervical Cancer Medicaid | Health Benefits/NC Medicaid | Form | pdf | 192 KB | | health-benefits-nc-medicaid | form |
| dhb-5087-sp Check List For Breast and Cervical Cancer Medicaid | Health Benefits/NC Medicaid | Form | pdf | 91 KB | | health-benefits-nc-medicaid | form |
| DHB-5095-ia Medicaid/Work First Notice of Inquiry | Health Benefits/NC Medicaid | Form | pdf | 167 KB | | health-benefits-nc-medicaid | form |
| DHB-5095sp-ia Aviso De Indagacion Sobre Medicaid/Work First | Health Benefits/NC Medicaid | Form | pdf | 261 KB | | health-benefits-nc-medicaid | form |
| DHB-5097 Request for Information | Health Benefits/NC Medicaid | Form | pdf | 238 KB | | health-benefits-nc-medicaid | form |
| DHB-5097 Chinese 資訊請求 | Health Benefits/NC Medicaid | Form | pdf | 186 KB | | health-benefits-nc-medicaid | form |
| DHB-5097 Chinese 資訊請求 | Health Benefits/NC Medicaid | Form | pdf | 186 KB | | health-benefits-nc-medicaid | form |
| DHB-5097 French Demande d’information | Health Benefits/NC Medicaid | Form | pdf | 308 KB | | health-benefits-nc-medicaid | form |
| DHB-5097 GU માહિતી માટેવિન ંતી | Health Benefits/NC Medicaid | Form | | | | health-benefits-nc-medicaid | form |
| DHB-5097 Hindi जानकारी हेतुअनुरोध | Health Benefits/NC Medicaid | Form | pdf | 302 KB | | health-benefits-nc-medicaid | form |
| DHB-5097 Korean-ia 정보 요청 | Adult Medicaid, Health Benefits/NC Medicaid | Form | pdf | 260 KB | | adult-medicaid health-benefits-nc-medicaid | form |
| DHB-5097 Mon-Khmer Cambodian សំេណើសុំព័ត៌មាន | Health Benefits/NC Medicaid | Form | pdf | 212 KB | | health-benefits-nc-medicaid | form |
| DHB-5097 Mon-Khmer Cambodian សំេណើសុំព័ត៌មាន | Health Benefits/NC Medicaid | Form | pdf | 212 KB | | health-benefits-nc-medicaid | form |
| DHB-5097_Arabic طلب الحصول على معلوما ت | Health Benefits/NC Medicaid | Form | pdf | 181 KB | | health-benefits-nc-medicaid | form |
| DHB-5097_Vietnamese Yêu cầu thông tin | Health Benefits/NC Medicaid | Form | pdf | 388 KB | | health-benefits-nc-medicaid | form |
| DHB-5097Russian Запрос информации | Health Benefits/NC Medicaid | Form | pdf | 186 KB | | health-benefits-nc-medicaid | form |
| DHB-5097sp-ia Solicitud de información | Health Benefits/NC Medicaid | Form | pdf | 206 KB | | health-benefits-nc-medicaid | form |
| DHB-5098-ia Your Application for Medicaid is Pending | Health Benefits/NC Medicaid | Form | pdf | 21 KB | | health-benefits-nc-medicaid | form |
| DHB-5104 Notice of Incomplete Application | Health Benefits/NC Medicaid | Form | pdf | 114 KB | | health-benefits-nc-medicaid | form |
| DHB-5104 Russian Уведомление о неполном заявлении | Health Benefits/NC Medicaid | Form | pdf | 88 KB | | health-benefits-nc-medicaid | form |
| DHB-5104sp Notificación de Solicitud Incompleta | Health Benefits/NC Medicaid | Form | pdf | 135 KB | | health-benefits-nc-medicaid | form |
| DHB-5104Vietnamese Thông báo về đơn đăng ký không đầy đủ | Health Benefits/NC Medicaid | Form | pdf | 111 KB | | health-benefits-nc-medicaid | form |
| dhb-5106 Medicaid Pace Program Referral | Health Benefits/NC Medicaid | Form | pdf | 280 KB | | health-benefits-nc-medicaid | form |
| DHB-5111 Annuity Verification Form | Health Benefits/NC Medicaid | Form | pdf | 115 KB | | health-benefits-nc-medicaid | form |
| DHB-5113, Notification of Right to Request an Undue Hardship Waiver (Transfer of Assets) | Health Benefits/NC Medicaid | Form | pdf | 149 KB | | health-benefits-nc-medicaid | form |
| DHB-5114-ia Request for Documentation for Undue Hardship Claim | Health Benefits/NC Medicaid | Form | pdf | 139 KB | | health-benefits-nc-medicaid | form |
| DHB-5115 Notification of Right to Request a Demonstrated Hardship Waiver (Home Equity Value) | Health Benefits/NC Medicaid | Form | pdf | 163 KB | | health-benefits-nc-medicaid | form |
| DHB-5118A-ia Medicaid Transportation Verification of Receipt of Covered Service – A | Health Benefits/NC Medicaid | Form | pdf | 36 KB | | health-benefits-nc-medicaid | form |
| DHB-5118B-ia Medicaid Transportation Verification of Receipt of Covered Service- B | Health Benefits/NC Medicaid | Form | pdf | 41 KB | | health-benefits-nc-medicaid | form |
| DHB-5119 Denial of Transportation Request(s) | Health Benefits/NC Medicaid | Form | pdf | 101 KB | | health-benefits-nc-medicaid | form |
| DHB-5119sp Negación de Solicitudes de Transporte | Health Benefits/NC Medicaid | Form | pdf | 101 KB | | health-benefits-nc-medicaid | form |
| dhb-5121 Determining Potential Medicaid Eligibility | Health Benefits/NC Medicaid | Form | pdf | 150 KB | | health-benefits-nc-medicaid | form |
| DHB-5122 Community Spouse Resource Protection Worksheet | Health Benefits/NC Medicaid | Form | pdf | 124 KB | | health-benefits-nc-medicaid | form |
| DHB-5125 Medicaid Transportation No-Show Notice | Health Benefits/NC Medicaid | Form | pdf | 80 KB | | health-benefits-nc-medicaid | form |
| DHB-5125a Medicaid Transportation No-Show Final Notice | Health Benefits/NC Medicaid | Form | pdf | 81 KB | | health-benefits-nc-medicaid | form |
| DHB-5125Asp Aviso final: Usted no usó el transporte de Medicaid | Health Benefits/NC Medicaid | Form | pdf | 173 KB | | health-benefits-nc-medicaid | form |
| DHB-5125B Medicaid Transportation Suspension Notice | Health Benefits/NC Medicaid | Form | pdf | 62 KB | | health-benefits-nc-medicaid | form |
| DHB-5125Bsp Aviso de Suspensión de Transporte de Medicaid | Health Benefits/NC Medicaid | Form | pdf | 122 KB | | health-benefits-nc-medicaid | form |
| DHB-5125sp Aviso: Usted no usó el transporte de Medicaid | Health Benefits/NC Medicaid | Form | pdf | 169 KB | | health-benefits-nc-medicaid | form |
| DHB-5146 Health Coverage for Workers with Disabilities Premium Notice | Health Benefits/NC Medicaid | Form | pdf | 126 KB | | health-benefits-nc-medicaid | form |
| DHB-5147 HCWD Denial for Non-Payment of Premiums | Health Benefits/NC Medicaid | Form | pdf | 137 KB | | health-benefits-nc-medicaid | form |
| DHB-5148 HCWD Termination for Non-Payment of Premiums | Health Benefits/NC Medicaid | Form | pdf | 216 KB | | health-benefits-nc-medicaid | form |
| DHB-5149 Health Coverage for Workers with Disabilities | Health Benefits/NC Medicaid | Form | pdf | 109 KB | | health-benefits-nc-medicaid | form |
| DHB-5150A PASS-ALONG SCREENING GUIDE | Health Benefits/NC Medicaid | Form | pdf | 272 KB | | health-benefits-nc-medicaid | form |
| DHB-5150B Screening for Medicaid Eligibility Under the COLA Pass-along | Health Benefits/NC Medicaid | Form | pdf | 269 KB | | health-benefits-nc-medicaid | form |
| DHB-5151 Health Coverage for Workers with Disabilities (HCWD) Medical Information Release Authorization | Health Benefits/NC Medicaid | Form | pdf | 88 KB | | health-benefits-nc-medicaid | form |
| DHB-5152 North Carolina Residency Declaration | Health Benefits/NC Medicaid | Form | pdf | 129 KB | | health-benefits-nc-medicaid | form |
| DHB-5152sp Declaración de residencia en Carolina del Norte | Health Benefits/NC Medicaid | Form | pdf | 110 KB | | health-benefits-nc-medicaid | form |
| DHB-5157, Notice Of Total Countable Resources; Right To Rebut Value | Health Benefits/NC Medicaid | Form | pdf | 132 KB | | health-benefits-nc-medicaid | form |
| DHB-5161 Transfer of Asset Below Current Market Value | Health Benefits/NC Medicaid | Form | pdf | 125 KB | | health-benefits-nc-medicaid | form |
| DHB-5164 Change to PML Request Memo | Health Benefits/NC Medicaid | Form | pdf | 207 KB | | health-benefits-nc-medicaid | form |
| DHB-5165 PACE Referral Request For A Medicaid Hearing | Health Benefits/NC Medicaid | Form | pdf | 159 KB | | health-benefits-nc-medicaid | form |
| DHB-5166 PACE Application Report | Health Benefits/NC Medicaid | Form | pdf | 194 KB | | health-benefits-nc-medicaid | form |
| DHB-5170 Request for Claims Override | Health Benefits/NC Medicaid | Form | pdf | 242 KB | | health-benefits-nc-medicaid | form |
| DHB-5175 Marriage Verification | Health Benefits/NC Medicaid | Form | pdf | 36 KB | | health-benefits-nc-medicaid | form |
| DHB-5179 MAABD Eligibility Overview Chart | Health Benefits/NC Medicaid | Form | pdf | 156 KB | | health-benefits-nc-medicaid | form |
| DHB-5181 5181 Calculating Penalty Period | Health Benefits/NC Medicaid | Form | pdf | 117 KB | | health-benefits-nc-medicaid | form |
| DHB-5200 Tagalog-ia Aplikasyon para sa Saklaw sa Kalusugan at Tulong sa Pagbabayad ng mga Gastos | Forms in Other Languages, Health Benefits/NC Medicaid | Form | pdf | 816 KB | | forms-in-other-languages health-benefits-nc-medicaid social-services | form |
| DHB-5200 Vietnamese-ia Đơn đăng ký Bảo hiểm Y tế & Trợ giúp Thanh toán Chi phí | Health Benefits/NC Medicaid | Form | pdf | 886 KB | | health-benefits-nc-medicaid | form |
| DHB-5200-ia Application for Health Coverage & Help Paying Costs | Health Benefits/NC Medicaid | Form | pdf | 916 KB | | health-benefits-nc-medicaid | form |
| DHB-5200-ia French Demande de couverture santé et d’aide au paiement des coûts | Health Benefits/NC Medicaid | Form | pdf | 398 KB | | health-benefits-nc-medicaid | form |
| DHB-5200sp Solicitud Para Cobertura de Salud y Ayuda Para Pagar los Costos | Health Benefits/NC Medicaid | Form | pdf | 2 MB | | health-benefits-nc-medicaid | form |
| DHB-5201-ia Application for Health Coverage & Help Paying Costs (Short Form) | Health Benefits/NC Medicaid | Form | pdf | 568 KB | | health-benefits-nc-medicaid | form |
| DHB-5202 Appendix E Chinese 附录 E | Health Benefits/NC Medicaid | Form | pdf | 205 KB | | health-benefits-nc-medicaid | form |
| DHB-5202 Vietnamese-ia PHỤ LỤC C – Chỉ định người đại diện được ủy quyền | Health Benefits/NC Medicaid | Form | pdf | 168 KB | | health-benefits-nc-medicaid | form |
| DHB-5202C-ia Designation of Authorized Representative – Appendix C | Health Benefits/NC Medicaid | Form | pdf | 155 KB | | health-benefits-nc-medicaid | form |
| DHB-5202E-ia Medical Bills – Appendix E | Health Benefits/NC Medicaid | Form | pdf | 215 KB | | health-benefits-nc-medicaid | form |
| DHB-5202Esp-ia Apéndice E – Facturas médicas | Health Benefits/NC Medicaid | Form | pdf | 119 KB | | health-benefits-nc-medicaid | form |
| DHB-5203 Transfer of Assets Evaluation Form Effective 9/1/2025 | Health Benefits/NC Medicaid | Form | pdf | 228 KB | | health-benefits-nc-medicaid | form |
| DHB-7058 Investigative Summary | Health Benefits/NC Medicaid | Form | pdf | 1 MB | | health-benefits-nc-medicaid | form |
| dhb-7059 Notice Of Change In Overpayment For Medical Assistance | Health Benefits/NC Medicaid | Form | pdf | 94 KB | | health-benefits-nc-medicaid | form |
| dhb-7060 Voluntarty Repayment Agreement | Health Benefits/NC Medicaid | Form | pdf | 853 KB | | health-benefits-nc-medicaid | form |
| dhb-7061 Voluntary Wage Withholding Agreement | Health Benefits/NC Medicaid | Form | pdf | 173 KB | | health-benefits-nc-medicaid | form |
| dhb-7063 Medicaid/NC Health Choice Recipient Profile Request Sheet Apr 21, 2021 | Health Benefits/NC Medicaid | Form | pdf | 298 KB | | health-benefits-nc-medicaid | form |
| DHB-7078A Application 2nd Party Review Worksheet | Health Benefits/NC Medicaid | Form | pdf | 733 KB | | health-benefits-nc-medicaid | form |
| DHB-7078R Recertification 2nd Party Review Worksheet | Health Benefits/NC Medicaid | Form | pdf | 590 KB | | health-benefits-nc-medicaid | form |
| dhb-7097-ia Recipient Request and Authorization to Disclose Health Information | Health Benefits/NC Medicaid | Form | pdf | 175 KB | | health-benefits-nc-medicaid | form |
| dhb-7098-I DMA-7098 – Additional Information and Instructions Feb 23, 2021 | Health Benefits/NC Medicaid | Form | pdf | 146 KB | | health-benefits-nc-medicaid | form |
| dhb-8010 Notice of Overpayment For Medical Assistance | Health Benefits/NC Medicaid | Form | pdf | 217 KB | | health-benefits-nc-medicaid | form |
| dhb-8010sp Notice of Overpayment For Medical Assistance (Spanish Version) | Health Benefits/NC Medicaid | Form | pdf | 131 KB | | health-benefits-nc-medicaid | form |
| DHB-8020-ia Medicaid Eligibility Corrections Form | Health Benefits/NC Medicaid | Form | pdf | 323 KB | | health-benefits-nc-medicaid | form |
| DMA 9006sp Formulario de inscripción en CCNC/CA | Health Benefits/NC Medicaid | Form | pdf | 133 KB | | health-benefits-nc-medicaid | form |
| DMA ADMINISTRATIVE LETTER NO: 01-17, Achieving A Better Life Experience (Able Act) | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 88 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 01-18, Social Security and VA Cost-of-Living Adjustment | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 11 MB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 02-16, 2016 Federal Poverty Level Changes | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 215 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 02-18, 2018 Federal Poverty Level (FPL) Changes and Cost of Living (COLA) Disregard | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 24 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 02-19, The Work Number Procedures | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 134 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 03-16, Spousal Impovershment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 144 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 03-17, Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 100 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 03-18, Hospital Provider Instructions for Determining Presumptive Eligibility | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 434 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 04-16, Obsolete Forms | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 152 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 05-18, Spousal Impoverishment Standards | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 153 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 06-18, ADDENDUM 2, Medicaid Procedures for Hurricane Florence | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 100 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 06-18, Emergency Medicaid Procedures for Hurricane Florence Victims | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 50 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 07-16, Addendum 1, Social Security And Va Cost-Of-Living Adjustment | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 2 MB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 07-16, Social Security And Va Cost-Of-Living Adjustment | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 385 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 07-19, Social Security and VA Cost-Of-Living Adjustment | Adult Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 379 KB | | adult-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 01-15, Spousal Impoverishment Standards | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 184 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 01-17, Achieving A Better Life Experience (Able Act) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 24 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 01-18, Social Security And VA Cost-Of-Living Adjustment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 11 MB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 01-19, Extension of Eligibility at Recertification | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 202 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 02-15, Title IV-E And Special Needs Adoption Children | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 344 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 02-16, Federal Poverty Level Changes | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 215 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 02-18, 2018 Federal Poverty Level (FPL) Changes And Cost Of Living Adjustment (COLA) Disregard | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 24 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 02-19, The Work Number Procedures | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 134 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 03-16, Spousal Impoverishment Standards | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 144 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 03-17, Spousal Impoverishment Standards | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 100 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 03-18, Hospital Provider Instructions For Determining Presumptive Eligibility | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 434 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 03-19, Hawkins V. Cohen Procedures- Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 272 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 04-15, Certification Period | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 9 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 04-16, Obsolete Forms | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 152 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 04-18, DAAS ADMINISTRATIVE LETTER NO. 18-03, Systematic Alien Verification For Entitlements (Save) Paperless Verification Processing | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 186 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 04-19, Medicaid Verification Reports | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 68 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 05-15, Social Security And VA Cost-Of-Living Adjustment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 385 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 05-19, Spousal Impoverishment Standards | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 16 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 06-15, Unconverted Medicaid Cases | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 51 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 06-18, ADDENDUM 2, Medicaid Procedures For Hurricane Florence | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 100 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 06-18, Emergency Medicaid Procedures For Hurricane Florence Victims | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 50 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 06-19, ADDENDUM 1, Medicaid Procedures for Hurricane Dorian | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 228 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 06-19,Medicaid Procedures for Hurricane Dorian – Obsolete | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 827 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 07-16, Social Security And VA Cost-Of-Living Adjustment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 385 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 07-19, Social Security and VA Cost-Of-Living Adjustment | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 379 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| dma-0100 Physician’s Signature for Authorization of Level of Care | Health Benefits/NC Medicaid | Form | pdf | 89 KB | | health-benefits-nc-medicaid | form |
| dma-1049 Cover Letter for LIS Application for Medicaid | Health Benefits/NC Medicaid | Form | pdf | 12 KB | | health-benefits-nc-medicaid | form |
| dma-1050 Notice of Application for Extra Help with Medicare Prescription Drug Costs | Health Benefits/NC Medicaid | Form | pdf | 13 KB | | health-benefits-nc-medicaid | form |
| dma-1051 LIS Verification Checklist | Health Benefits/NC Medicaid | Form | pdf | 65 KB | | health-benefits-nc-medicaid | form |
| dma-1051-ia LIS Verification Checklist | Health Benefits/NC Medicaid | Form | pdf | 170 KB | | health-benefits-nc-medicaid | form |
| dma-1052 Notice of Approval for Extra Help with Medicaire Prescription Drug Costs | Health Benefits/NC Medicaid | Form | pdf | 28 KB | | health-benefits-nc-medicaid | form |
| dma-1052-ia Notice of Approval for Extra Help with Medicare Prescription Drug Costs | Health Benefits/NC Medicaid | Form | pdf | 76 KB | | health-benefits-nc-medicaid | form |
| dma-1053 Medicare Prescription Drug Subsidy Assistance | Health Benefits/NC Medicaid | Form | pdf | 45 KB | | health-benefits-nc-medicaid | form |
| dma-1053-ia Medicare Prescription Drug Subsidy Assistance | Health Benefits/NC Medicaid | Form | pdf | 45 KB | | health-benefits-nc-medicaid | form |
| dma-1054 Report of Approval/Denial of LIS Application | Health Benefits/NC Medicaid | Form | pdf | 32 KB | | health-benefits-nc-medicaid | form |
| dma-2000a County DSS Request for DMA Forms | Health Benefits/NC Medicaid | Form | pdf | 100 KB | | health-benefits-nc-medicaid | form |
| dma-2000h Health Agencies Request for DMA Forms | Health Benefits/NC Medicaid | Form | pdf | 158 KB | | health-benefits-nc-medicaid | form |
| dma-2000x Order Form for NC Medicaid Consumer Guides | Health Benefits/NC Medicaid | Form | pdf | 82 KB | | health-benefits-nc-medicaid | form |
| dma-2041-ia Third Party Recovery Insurance Information | Health Benefits/NC Medicaid | Form | pdf | 106 KB | | health-benefits-nc-medicaid | form |
| dma-2046 Third Party Liability Medicaid and NC Health Choice Billing Guide | Health Benefits/NC Medicaid | Form | pdf | 484 KB | | health-benefits-nc-medicaid | form |
| dma-2053-ia Insurance Company Code Request Form | Health Benefits/NC Medicaid | Form | pdf | 89 KB | | health-benefits-nc-medicaid | form |
| dma-2057 Health Insurance Information Referral Form | Health Benefits/NC Medicaid | Form | pdf | 5 KB | | health-benefits-nc-medicaid | form |
| dma-2069 Health Insurance Premium Payment Program Application | Health Benefits/NC Medicaid | Form | pdf | 140 KB | | health-benefits-nc-medicaid | form |
| dma-2073 Medicaid Payment Information Request | Health Benefits/NC Medicaid | Form | pdf | 28 KB | | health-benefits-nc-medicaid | form |
| dma-2073-I Instructions for Medicaid Payment Information Request | Health Benefits/NC Medicaid | Form | pdf | 17 KB | | health-benefits-nc-medicaid | form |
| DMA-2188 Chinese 北卡罗来纳州医疗援助司 | Health Benefits/NC Medicaid | Form | pdf | 306 KB | | health-benefits-nc-medicaid | form |
| DMA-2188 French AVIS SUR LES PRATIQUES EN MATIÈRE DE PROTECTION DE LA VIE PRIVÉE | Health Benefits/NC Medicaid | Form | pdf | 149 KB | | health-benefits-nc-medicaid | form |
| dma-2188 Notice of Privacy Practices | Health Benefits/NC Medicaid | Form | pdf | 137 KB | | health-benefits-nc-medicaid | form |
| dma-2188sp Aviso De Pr√°cticas De Privacidad | Health Benefits/NC Medicaid | Form | pdf | 46 KB | | health-benefits-nc-medicaid | form |
| dma-2190 Report of Internal Inspection FRR/BEER | Health Benefits/NC Medicaid | Form | pdf | 717 KB | | health-benefits-nc-medicaid | form |
| dma-2191 Designation of Control Officer for FRR/BEER | Health Benefits/NC Medicaid | Form | pdf | 656 KB | | health-benefits-nc-medicaid | form |
| dma-2192 Documentation of SSA Security Training | Health Benefits/NC Medicaid | Form | pdf | 680 KB | | health-benefits-nc-medicaid | form |
| dma-3002 Program Care Coordinator Pregnancy Outcome Report | Health Benefits/NC Medicaid | Form | pdf | 112 KB | | health-benefits-nc-medicaid | form |
| dma-3004 Maternity Care Coordination Letter of Agreement | Health Benefits/NC Medicaid | Form | pdf | 31 KB | | health-benefits-nc-medicaid | form |
| dma-3005 Care Coordinator Appointment Record | Health Benefits/NC Medicaid | Form | pdf | 45 KB | | health-benefits-nc-medicaid | form |
| dma-3006 Care Coordination Record | Health Benefits/NC Medicaid | Form | pdf | 165 KB | | health-benefits-nc-medicaid | form |
| dma-3007-ia Family Care Coordination Plan | Health Benefits/NC Medicaid | Form | pdf | 207 KB | | health-benefits-nc-medicaid | form |
| dma-3016 Care Coordination Narrative Sheet | Health Benefits/NC Medicaid | Form | pdf | 44 KB | | health-benefits-nc-medicaid | form |
| dma-3019 Individual Authorization Form | Health Benefits/NC Medicaid | Form | pdf | 47 KB | | health-benefits-nc-medicaid | form |
| dma-3047 Hysterectomy Statement Form | Health Benefits/NC Medicaid | Form | pdf | 139 KB | | health-benefits-nc-medicaid | form |
| dma-3050R Adult Care Home Personal Care Physician | Health Benefits/NC Medicaid | Form | pdf | 37 KB | | health-benefits-nc-medicaid | form |
| dma-3055 Family Planning Waiver New Enrollee Letter | Health Benefits/NC Medicaid | Form | pdf | 35 KB | | health-benefits-nc-medicaid | form |
| dma-3055R-I Instructions for Completing the Revised Adult Care Home Personal Care Physician Authorization and Care Plan (DMA-3050R) | Health Benefits/NC Medicaid | Form | pdf | 38 KB | | health-benefits-nc-medicaid | form |
| dma-3057-ia North Carolina Community Alternatives Program for Children Participation Notice | Health Benefits/NC Medicaid | Form | pdf | 97 KB | | health-benefits-nc-medicaid | form |
| dma-3059-ia Sterilization Consent Form | Health Benefits/NC Medicaid | Form | pdf | 242 KB | | health-benefits-nc-medicaid | form |
| dma-3063-ia CAP/C – Physician’s Request Form for In-Home Nursing Services | Health Benefits/NC Medicaid | Form | pdf | 36 KB | | health-benefits-nc-medicaid | form |
| dma-3065 PCS Medical Attestation for Licensed Care Home Residents | Health Benefits/NC Medicaid | Form | pdf | 248 KB | | health-benefits-nc-medicaid | form |
| dma-3066 PCS for Licensed ACH Residents – Independent Assessment request for New Residents | Health Benefits/NC Medicaid | Form | pdf | 231 KB | | health-benefits-nc-medicaid | form |
| dma-3072-ia Self-Assessment Tools | Health Benefits/NC Medicaid | Form | pdf | 273 KB | | health-benefits-nc-medicaid | form |
| dma-3073-ia Individual Risk Assessment | Health Benefits/NC Medicaid | Form | pdf | 41 KB | | health-benefits-nc-medicaid | form |
| dma-3085-I- Session Law 2013-306 PCS Training Attestation Form DMA-3085 | Health Benefits/NC Medicaid | Form | pdf | 33 KB | | health-benefits-nc-medicaid | form |
| dma-3085-ia Session Law 2013-306 PCS Training Attestation Form May 30, 2018 | Health Benefits/NC Medicaid | Form | | | | health-benefits-nc-medicaid | form |
| dma-3087-ia Service Request for Home and Community-Based Services – PHYSICIANS ATTESTATION | Health Benefits/NC Medicaid | Form | pdf | 441 KB | | health-benefits-nc-medicaid | form |
| dma-3114-I-ia Instructions – Request for Reconsideration of PCS Authorization (DMA-3114) | Health Benefits/NC Medicaid | Form | pdf | 274 KB | | health-benefits-nc-medicaid | form |
| dma-3114-ia Request for Reconsideration of PCS Authorization | Health Benefits/NC Medicaid | Form | pdf | 201 KB | | health-benefits-nc-medicaid | form |
| dma-3116-I Instructions – Personal Care Services EPSDT Short-Term Increase-In-Hours Request Form (DMA-3116) | Health Benefits/NC Medicaid | Form | pdf | 226 KB | | health-benefits-nc-medicaid | form |
| dma-3116-ia Personal Care Services EPSDT Short-Term Increase-In-Hours Request Form | Health Benefits/NC Medicaid | Form | pdf | 526 KB | | health-benefits-nc-medicaid | form |
| dma-3125 Oral Nutrition Product Request Form | Health Benefits/NC Medicaid | Form | pdf | 30 KB | | health-benefits-nc-medicaid | form |
| dma-3136-ia Internal Quality Improvement Program Attestation Form | Health Benefits/NC Medicaid | Form | pdf | 213 KB | | health-benefits-nc-medicaid | form |
| dma-3136-ia-i Internal Quality Improvement Program Attestation Form – Instructions | Health Benefits/NC Medicaid | Form | pdf | 32 KB | | health-benefits-nc-medicaid | form |
| dma-3137 Personal Care Services (PCS) ICD-10 Transition Form Jun 01, 2018 | Health Benefits/NC Medicaid | Form | | | | health-benefits-nc-medicaid | form |
| dma-3137-i Personal Care Services (PCS) ICD-10 Transition Form – Instructions | Health Benefits/NC Medicaid | Form | pdf | 298 KB | | health-benefits-nc-medicaid | form |
| dma-3142-ia Abortion Statement (DMA-3142-IA) | Health Benefits/NC Medicaid | Form | pdf | 127 KB | | health-benefits-nc-medicaid | form |
| dma-3155 HIV Case Management – Medical Home Communication Tracker | Health Benefits/NC Medicaid | Form | pdf | 543 KB | | health-benefits-nc-medicaid | form |
| dma-3156 HIV Case Management – Continuing Education Hours Approval Form | Health Benefits/NC Medicaid | Form | pdf | 684 KB | | health-benefits-nc-medicaid | form |
| dma-3157 HIV Case Management Provider Recertification Application Checklist | Health Benefits/NC Medicaid | Form | pdf | 213 KB | | health-benefits-nc-medicaid | form |
| dma-3158 HIV Case Management Provider Recertification Application | Health Benefits/NC Medicaid | Form | pdf | 128 KB | | health-benefits-nc-medicaid | form |
| dma-3158-I HIV Case Management Provider Recertification Application – Instructions | Health Benefits/NC Medicaid | Form | pdf | 189 KB | | health-benefits-nc-medicaid | form |
| dma-3159 HIV Case Management Basic Training Request Form | Health Benefits/NC Medicaid | Form | pdf | 173 KB | | health-benefits-nc-medicaid | form |
| dma-3163-ia NC DMA – Community Alternatives Program for Children (CAP/C) Referral Form | Health Benefits/NC Medicaid | Form | pdf | 523 KB | | health-benefits-nc-medicaid | form |
| dma-3165-ia Notification of Hospice and Personal Care Services (PCS) Coordination Form | Health Benefits/NC Medicaid | Form | pdf | 414 KB | | health-benefits-nc-medicaid | form |
| dma-3171-I Verification of School Nursing – Instructions | Health Benefits/NC Medicaid | Form | pdf | 346 KB | | health-benefits-nc-medicaid | form |
| dma-3171-ia Verification of School Nursing | Health Benefits/NC Medicaid | Form | pdf | 442 KB | | health-benefits-nc-medicaid | form |
| dma-3172 Private Duty Nursing Employment Attestation Form | Health Benefits/NC Medicaid | Form | pdf | 250 KB | | health-benefits-nc-medicaid | form |
| dma-3173 Verification of Employment Form | Health Benefits/NC Medicaid | Form | pdf | 153 KB | | health-benefits-nc-medicaid | form |
| dma-3201-ia Critical Incident Report – Community Alternatives Program for Children (CAP-C) | Health Benefits/NC Medicaid | Form | pdf | 298 KB | | health-benefits-nc-medicaid | form |
| dma-3212-ia NC Medicaid Hospice Prior Approval Authorization | Health Benefits/NC Medicaid | Form | pdf | 110 KB | | health-benefits-nc-medicaid | form |
| dma-3350 Prior Approval Form for Lower Extremity Prosthetic Component L5781 or L5782 | Health Benefits/NC Medicaid | Form | pdf | 25 KB | | health-benefits-nc-medicaid | form |
| dma-3351 Prior Approval Form for Lower Extremity Prosthetic Component L5930 | Health Benefits/NC Medicaid | Form | pdf | 19 KB | | health-benefits-nc-medicaid | form |
| dma-3352 Prior Approval Form for Lower Extremity Prosthetic Component L5968 | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-3353 Prior Approval Form for Lower Extremity Prosthetic Component L5980 | Health Benefits/NC Medicaid | Form | pdf | 19 KB | | health-benefits-nc-medicaid | form |
| dma-3354 Prior Approval Form for Lower Extremity Prosthetic Component L5987 | Health Benefits/NC Medicaid | Form | pdf | 19 KB | | health-benefits-nc-medicaid | form |
| dma-3355 Prior Approval Form for Lower Extremity Prosthetic Component L5988 | Health Benefits/NC Medicaid | Form | pdf | 19 KB | | health-benefits-nc-medicaid | form |
| dma-3400 Request for HCPCS Code Addition – Medicaid Home Health Fee Schedule | Health Benefits/NC Medicaid | Form | pdf | 601 KB | | health-benefits-nc-medicaid | form |
| dma-3504 Notice of Approval of Service Request | Health Benefits/NC Medicaid | Form | pdf | 243 KB | | health-benefits-nc-medicaid | form |
| dma-3600 Tocolytic Prior Approval Request Form | Health Benefits/NC Medicaid | Form | pdf | 34 KB | | health-benefits-nc-medicaid | form |
| DMA-3611 Dupixent for Asthma | Health Benefits/NC Medicaid | Form | pdf | 114 KB | | health-benefits-nc-medicaid | form |
| dma-3701-ia N.C. Health Choice Extended Coverage | Health Benefits/NC Medicaid | Form | pdf | 92 KB | | health-benefits-nc-medicaid | form |
| dma-3701sp-ia Cobertura Extendida de NC Health Choice | Health Benefits/NC Medicaid | Form | pdf | 64 KB | | health-benefits-nc-medicaid | form |
| dma-372-124-ach-ia Adult Care Home FL2 Form | Health Benefits/NC Medicaid | Form | pdf | 213 KB | | health-benefits-nc-medicaid | form |
| dma-5001sp AVISO DEL USO DE NUMEROS DE SEGURO SOCIAL Feb 04, 2022 | Health Benefits/NC Medicaid | Form | | | | health-benefits-nc-medicaid | form |
| dma-5004 Buy-In Clerical Action | Health Benefits/NC Medicaid | Form | pdf | 204 KB | | health-benefits-nc-medicaid | form |
| dma-5008b-ia Long Term Care Budget Supplement B to DMA-5008 | Health Benefits/NC Medicaid | Form | pdf | 130 KB | | health-benefits-nc-medicaid | form |
| dma-5008c Spouse and Dependent Income Allowance Worksheet | Health Benefits/NC Medicaid | Form | pdf | 51 KB | | health-benefits-nc-medicaid | form |
| dma-5008c-ia Spouse and Dependent Income Allowance Worksheet | Health Benefits/NC Medicaid | Form | pdf | 63 KB | | health-benefits-nc-medicaid | form |
| dma-5008e ABD Medicaid Parent to Child Deeming Budget Sheet | Health Benefits/NC Medicaid | Form | pdf | 46 KB | | health-benefits-nc-medicaid | form |
| dma-5008e-ia ABD Medicaid Parent to Child Deeming Budget Sheet | Health Benefits/NC Medicaid | Form | pdf | 85 KB | | health-benefits-nc-medicaid | form |
| dma-5009 Social History Summary for the Disabled | Health Benefits/NC Medicaid | Form | pdf | 25 KB | | health-benefits-nc-medicaid | form |
| dma-5009-ia Social History Summary for the Disabled | Health Benefits/NC Medicaid | Form | pdf | 51 KB | | health-benefits-nc-medicaid | form |
| dma-5010-ia Referral for Inpatient Hospital and Intermediate Care Facility in State Mental Hospital/State Mental Retardation Centers | Health Benefits/NC Medicaid | Form | pdf | 474 KB | | health-benefits-nc-medicaid | form |
| dma-5011-ia Managed Care Organization (MCO) Health Plan Welcome Letter | Health Benefits/NC Medicaid | Form | pdf | 104 KB | | health-benefits-nc-medicaid | form |
| dma-5011a CAP Indicator Letter (Memorandum) | Health Benefits/NC Medicaid | Form | pdf | 11 KB | | health-benefits-nc-medicaid | form |
| dma-5012 Managed Care Organization (MCO) Health Plan Transfer Letter | Health Benefits/NC Medicaid | Form | pdf | 12 KB | | health-benefits-nc-medicaid | form |
| dma-5020 Notice of Case Status | Health Benefits/NC Medicaid | Form | pdf | 77 KB | | health-benefits-nc-medicaid | form |
| dma-5020-ia Notice of Case Status | Health Benefits/NC Medicaid | Form | pdf | 58 KB | | health-benefits-nc-medicaid | form |
| dma-5022-ia Eligibility Information System | Health Benefits/NC Medicaid | Form | pdf | 160 KB | | health-benefits-nc-medicaid | form |
| dma-5024sp-ia Notificacion de Solicitud de Transporte Jan 26, 2021 | Health Benefits/NC Medicaid | Form | | | | health-benefits-nc-medicaid | form |
| dma-5026 Notice of Obligation to Apply for Veteran’s Benefits | Health Benefits/NC Medicaid | Form | pdf | 23 KB | | health-benefits-nc-medicaid | form |
| dma-5027 Verification of VA Benefits | Health Benefits/NC Medicaid | Form | pdf | 23 KB | | health-benefits-nc-medicaid | form |
| dma-5031A Verification of Pregnancy | Health Benefits/NC Medicaid | Form | pdf | 27 KB | | health-benefits-nc-medicaid | form |
| dma-5032 Presumptive Eligibility Determination Form for Pregnancy – Related Care | Health Benefits/NC Medicaid | Form | pdf | 129 KB | | health-benefits-nc-medicaid | form |
| dma-5032-(H) Presumptive Eligibility Determination by Hospital | Health Benefits/NC Medicaid | Form | pdf | 522 KB | | health-benefits-nc-medicaid | form |
| dma-5032sp Formulario De Determinación De Elegibilidad Presunta Para Recibir Atención Relacionada Con El Embarazo | Health Benefits/NC Medicaid | Form | pdf | 43 KB | | health-benefits-nc-medicaid | form |
| dma-5033 Presumptive Eligibility Transmittal Form | Health Benefits/NC Medicaid | Form | pdf | 44 KB | | health-benefits-nc-medicaid | form |
| dma-5033sp Formulario De Transmisión De Elegibilidad Presunta | Health Benefits/NC Medicaid | Form | pdf | 121 KB | | health-benefits-nc-medicaid | form |
| dma-5034 Presumptive Eligibility Income Checklist | Health Benefits/NC Medicaid | Form | pdf | 149 KB | | health-benefits-nc-medicaid | form |
| dma-5034sp Lista de Verification de Ingresos Para Elegibilidad Presunta | Health Benefits/NC Medicaid | Form | pdf | 79 KB | | health-benefits-nc-medicaid | form |
| dma-5035 Presumptive Eligibility Denial | Health Benefits/NC Medicaid | Form | pdf | 78 KB | | health-benefits-nc-medicaid | form |
| dma-5035sp Denegacion de Elegibilidad Presunta | Health Benefits/NC Medicaid | Form | pdf | 17 KB | | health-benefits-nc-medicaid | form |
| dma-5036 Record of Medical Expenses Applied to the Deductible | Health Benefits/NC Medicaid | Form | pdf | 200 KB | | health-benefits-nc-medicaid | form |
| dma-5037 Medical Provider Verification Form | Health Benefits/NC Medicaid | Form | pdf | 12 KB | | health-benefits-nc-medicaid | form |
| dma-5039 Right to Rebut Value of Vehicles | Health Benefits/NC Medicaid | Form | pdf | 11 KB | | health-benefits-nc-medicaid | form |
| dma-5041 Doctor’s Statement of Due Date | Health Benefits/NC Medicaid | Form | pdf | 16 KB | | health-benefits-nc-medicaid | form |
| dma-5042 Mail-In Application, Additional Information | Health Benefits/NC Medicaid | Form | pdf | 11 KB | | health-benefits-nc-medicaid | form |
| dma-5042-ia Additional Information Needed for Mail-In Application | Health Benefits/NC Medicaid | Form | pdf | 29 KB | | health-benefits-nc-medicaid | form |
| dma-5044 Consent for Release of Information | Health Benefits/NC Medicaid | Form | pdf | 22 KB | | health-benefits-nc-medicaid | form |
| dma-5045 Certification of Need For Institutional Care for Individual Under Age 21 | Health Benefits/NC Medicaid | Form | pdf | 18 KB | | health-benefits-nc-medicaid | form |
| dma-5050-ia Emergency Certification for Medicaid | Health Benefits/NC Medicaid | Form | pdf | 73 KB | | health-benefits-nc-medicaid | form |
| dma-5055-ia Third Party Resource Transmittal | Health Benefits/NC Medicaid | Form | pdf | 16 KB | | health-benefits-nc-medicaid | form |
| dma-5057 Explanation Of The Effect Of Transfer Of Asset (s) On Medical Assistance Eligibility | Health Benefits/NC Medicaid | Form | pdf | 30 KB | | health-benefits-nc-medicaid | form |
| DMA-5057 French EXPLICATION DE L’EFFET DU TRANSFERT D’ACTIF(S) SUR L’ÉLIGIBILITÉ À L’ASSISTANCE MÉDICALE | Health Benefits/NC Medicaid | Form | pdf | 111 KB | | health-benefits-nc-medicaid | form |
| DMA-5057 Gujarati સંપિ�(ઓ) ના ટ� ાન્સફરના પ્રભાવની સમજૂતી તબીબી સહાયતા પાત્રતા િવશ | Health Benefits/NC Medicaid | Form | pdf | 150 KB | | health-benefits-nc-medicaid | form |
| dma-5057sp Explicación De Los Efectos De La Transferencia De Activos Sobre La Elegibilidad Para Asistencia Médica | Health Benefits/NC Medicaid | Form | pdf | 32 KB | | health-benefits-nc-medicaid | form |
| dma-5058 Participating Telephone Service Providers | Health Benefits/NC Medicaid | Form | pdf | 19 KB | | health-benefits-nc-medicaid | form |
| dma-5066 NC Health Choice/Medicaid Mail-In Applications – Log | Health Benefits/NC Medicaid | Form | pdf | 40 KB | | health-benefits-nc-medicaid | form |
| dma-5066-ia NC Health Choice/Medicaid Mail-In Applications – Log | Health Benefits/NC Medicaid | Form | pdf | 32 KB | | health-benefits-nc-medicaid | form |
| dma-5069 Special Health Care Needs Questionnaire | Health Benefits/NC Medicaid | Form | pdf | 68 KB | | health-benefits-nc-medicaid | form |
| dma-5069sp Cuestionario para Necesidades Especiades de Salud | Health Benefits/NC Medicaid | Form | pdf | 99 KB | | health-benefits-nc-medicaid | form |
| dma-5071i NC Health Choice Designation of Authorized Representative Form | Health Benefits/NC Medicaid | Form | pdf | 62 KB | | health-benefits-nc-medicaid | form |
| dma-5071sp NC Health Choice: Designación De Representante Autorizo | Health Benefits/NC Medicaid | Form | pdf | 86 KB | | health-benefits-nc-medicaid | form |
| dma-5072i NC Health Choice First Level Review Request Form | Health Benefits/NC Medicaid | Form | pdf | 174 KB | | health-benefits-nc-medicaid | form |
| dma-5072sp Explicación Del Proceso De Revisión De Primer Nivel | Health Benefits/NC Medicaid | Form | pdf | 62 KB | | health-benefits-nc-medicaid | form |
| dma-5073-ia NC Health Choice – External Second Level Review Request Form | Health Benefits/NC Medicaid | Form | pdf | 253 KB | | health-benefits-nc-medicaid | form |
| dma-5073sp Explanación Del Proceso De Revisión De Segundo Nivel | Health Benefits/NC Medicaid | Form | pdf | 270 KB | | health-benefits-nc-medicaid | form |
| dma-5086 Request for Access to DHHS Provider Penalty Tracking Database | Health Benefits/NC Medicaid | Form | pdf | 70 KB | | health-benefits-nc-medicaid | form |
| dma-5093-ia DAILY RECEPTION LOG FOR MEDICAL AND FINANCIAL ASSISTANCE | Health Benefits/NC Medicaid | Form | pdf | 60 KB | | health-benefits-nc-medicaid | form |
| dma-5094 Notice of Your Right to Apply for Benefits | Health Benefits/NC Medicaid | Form | pdf | 36 KB | | health-benefits-nc-medicaid | form |
| DMA-5094 French AVIS SUR VOTRE DROIT DE DEMANDER DES PRESTATIONS | Health Benefits/NC Medicaid | Form | pdf | 116 KB | | health-benefits-nc-medicaid | form |
| dma-5094sp Aviso de Su Derecho a Solicitar Beneficios | Health Benefits/NC Medicaid | Form | pdf | 80 KB | | health-benefits-nc-medicaid | form |
| dma-5096-ia Documentation of Need | Health Benefits/NC Medicaid | Form | pdf | 174 KB | | health-benefits-nc-medicaid | form |
| dma-5097-ia Request for Information | Health Benefits/NC Medicaid | Form | pdf | 51 KB | | health-benefits-nc-medicaid | form |
| dma-5097sp Solicitud de información | Health Benefits/NC Medicaid | Form | pdf | 41 KB | | health-benefits-nc-medicaid | form |
| dma-5098sp-ia Su Solicitud Para Medicaid Esta Pendiente | Health Benefits/NC Medicaid | Form | pdf | 85 KB | | health-benefits-nc-medicaid | form |
| dma-5100 Notice of Medicaid Redetermination | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5100sp Aviso De Redeterminación De Medicaid | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5100sp Aviso De Redeterminación De Medicaid | Health Benefits/NC Medicaid | Form | pdf | 29 KB | | health-benefits-nc-medicaid | form |
| dma-5101 Notice of Approval | Health Benefits/NC Medicaid | Form | pdf | 28 KB | | health-benefits-nc-medicaid | form |
| dma-5102 SSI Denial | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5102sp Negación de SSI | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5103D SSI Medicaid Denial Due to Refusal to Provide Health Insurance Information | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5103Dsp Denegación De Medicaid Por Medio De La Ssi Debido A La Negativa De Suministrar Información Sobre El Seguro De Salud | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5103T SSA Medicaid Termination Due to Refusal to Provide Health Insurance Information | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5103Tsp Cancelación De Medicaid Por Medio De La Ssi Debido A La Negativa De Suministrar Información Sobre El Seguro De Salud | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5105 Adult Mail-In Application Log | Health Benefits/NC Medicaid | Form | pdf | 17 KB | | health-benefits-nc-medicaid | form |
| dma-5105-ia Adult Mail-In Application Log | Health Benefits/NC Medicaid | Form | pdf | 32 KB | | health-benefits-nc-medicaid | form |
| dma-5108 Provider Transportation Record | Health Benefits/NC Medicaid | Form | pdf | 80 KB | | health-benefits-nc-medicaid | form |
| dma-5109 Model No-Show Policy for Community Transportation Systems | Health Benefits/NC Medicaid | Form | pdf | 116 KB | | health-benefits-nc-medicaid | form |
| dma-5110-ia Disclosure of Annuities | Health Benefits/NC Medicaid | Form | pdf | 26 KB | | health-benefits-nc-medicaid | form |
| dma-5111-ia Verification of Annuities Properties | Health Benefits/NC Medicaid | Form | pdf | 82 KB | | health-benefits-nc-medicaid | form |
| dma-5112-ia Informational Notice Regarding Annuities and Medicaid Eligibility | Health Benefits/NC Medicaid | Form | pdf | 26 KB | | health-benefits-nc-medicaid | form |
| dma-5114-ia Request for Documentation for Undue Hardship Claim | Health Benefits/NC Medicaid | Form | pdf | 134 KB | | health-benefits-nc-medicaid | form |
| dma-5115-ia Notification of Right to Request a Demonstrated Hardship Waiver (Home Equity Value) | Health Benefits/NC Medicaid | Form | pdf | 28 KB | | health-benefits-nc-medicaid | form |
| dma-5122 Community Spouse Resource Protection Worksheet | Health Benefits/NC Medicaid | Form | pdf | 142 KB | | health-benefits-nc-medicaid | form |
| dma-5124 Medicaid Transportation Provider Documentation | Health Benefits/NC Medicaid | Form | pdf | 31 KB | | health-benefits-nc-medicaid | form |
| dma-5124a Medicaid Transportation Provider Documentation Addendum | Health Benefits/NC Medicaid | Form | pdf | 84 KB | | health-benefits-nc-medicaid | form |
| dma-5127 Notice of Reactivating The Health Check/Health Choice Program | Health Benefits/NC Medicaid | Form | pdf | 55 KB | | health-benefits-nc-medicaid | form |
| dma-5127sp Notice of Reactivating The Health Check/Health Choice Program | Health Benefits/NC Medicaid | Form | pdf | 54 KB | | health-benefits-nc-medicaid | form |
| dma-5128 Health Choice Enrollment & Waiting List Notification | Health Benefits/NC Medicaid | Form | pdf | 25 KB | | health-benefits-nc-medicaid | form |
| dma-5128sp Registro de Health Choice & Lista de Espera Notification | Health Benefits/NC Medicaid | Form | pdf | 44 KB | | health-benefits-nc-medicaid | form |
| dma-5131 FAX Request Form – From County DSS to EOIR | Health Benefits/NC Medicaid | Form | pdf | 21 KB | | health-benefits-nc-medicaid | form |
| dma-5132 FAX Request Form – From County DSS to USCIS | Health Benefits/NC Medicaid | Form | pdf | 24 KB | | health-benefits-nc-medicaid | form |
| dma-5133 Emergency Medical Services Request for Information | Health Benefits/NC Medicaid | Form | pdf | 13 KB | | health-benefits-nc-medicaid | form |
| dma-5134 Emergency Medical Services Request for Missing Information | Health Benefits/NC Medicaid | Form | pdf | 20 KB | | health-benefits-nc-medicaid | form |
| dma-5135 Dates of Emergency Services Requested for an Alien | Health Benefits/NC Medicaid | Form | pdf | 39 KB | | health-benefits-nc-medicaid | form |
| dma-5141 Medicare/Medicare Part B Enrollment Advisory Letter (Automated) | Health Benefits/NC Medicaid | Form | pdf | 27 KB | | health-benefits-nc-medicaid | form |
| dma-5154 County Transfer Letter | Health Benefits/NC Medicaid | Form | pdf | 19 KB | | health-benefits-nc-medicaid | form |
| dma-5154 sp County Transfer Letter | Health Benefits/NC Medicaid | Form | pdf | 126 KB | | health-benefits-nc-medicaid | form |
| dma-5154-ia County Transfer Letter | Health Benefits/NC Medicaid | Form | pdf | 31 KB | | health-benefits-nc-medicaid | form |
| DMA-5154sp-ia CARTA DE TRASLADO DE CONDADO | Health Benefits/NC Medicaid | Form | pdf | 120 KB | | health-benefits-nc-medicaid | form |
| dma-5155 Verification of Cash Value of Life Insurance | Health Benefits/NC Medicaid | Form | pdf | 18 KB | | health-benefits-nc-medicaid | form |
| dma-5156 Statement of Outstanding Checks | Health Benefits/NC Medicaid | Form | pdf | 11 KB | | health-benefits-nc-medicaid | form |
| dma-5157 Notice of Total Countable Resources; Right To Rebut Value | Health Benefits/NC Medicaid | Form | pdf | 16 KB | | health-benefits-nc-medicaid | form |
| DMA-5157 SP Notice of Total Countable Resources; Right to Rebute Value | Health Benefits/NC Medicaid | Form | pdf | 160 KB | | health-benefits-nc-medicaid | form |
| DMA-5157 Vietnamese THÔNG BÁO VỀ TỔNG GIÁ TRỊ TÀI SẢN ĐẾM ĐƯỢC; QUYỀN PHẢN BÁC GIÁ TRỊ | Health Benefits/NC Medicaid | Form | pdf | 179 KB | | health-benefits-nc-medicaid | form |
| dma-5158 INCOME PRODUCING PROPERTY GUIDE | Health Benefits/NC Medicaid | Form | pdf | 102 KB | | health-benefits-nc-medicaid | form |
| dma-5159 Statement of Intent to Return Home | Health Benefits/NC Medicaid | Form | pdf | 12 KB | | health-benefits-nc-medicaid | form |
| dma-5160 Statement Of Spouse Or Dependent Relative In The Home | Health Benefits/NC Medicaid | Form | pdf | 12 KB | | health-benefits-nc-medicaid | form |
| dma-5161 Transfer Of Asset Below Current Market Value Important Notice | Health Benefits/NC Medicaid | Form | pdf | 24 KB | | health-benefits-nc-medicaid | form |
| dma-5167 County Analysis – Non-Compliance with Processing Thresholds or Thresholds for Denials, Withdrawals, Inquiries | Health Benefits/NC Medicaid | Form | pdf | 383 KB | | health-benefits-nc-medicaid | form |
| dma-5168 Actions Taken On Improper Denials, Withdrawals, Or Inquiries Identified In Monitoring | Health Benefits/NC Medicaid | Form | pdf | 177 KB | | health-benefits-nc-medicaid | form |
| dma-5169 Report Card Analysis | Health Benefits/NC Medicaid | Form | pdf | 186 KB | | health-benefits-nc-medicaid | form |
| dma-5171 Approval Notice For Retroactive Medicaid Benefits | Health Benefits/NC Medicaid | Form | pdf | 12 KB | | health-benefits-nc-medicaid | form |
| dma-5172 Erroneous Authorization Dates of Medicaid Eligibility | Health Benefits/NC Medicaid | Form | pdf | 14 KB | | health-benefits-nc-medicaid | form |
| dma-5176 U.S. Citizenship Documentation Birth Certificate Request | Health Benefits/NC Medicaid | Form | pdf | 12 KB | | health-benefits-nc-medicaid | form |
| dma-5178 U.S. Citizenship Documentation Desk Reference | Health Benefits/NC Medicaid | Form | pdf | 37 KB | | health-benefits-nc-medicaid | form |
| dma-5180 SSI Check Terminated: Information Needed to Determine Medicaid Eligibility | Health Benefits/NC Medicaid | Form | pdf | 336 KB | | health-benefits-nc-medicaid | form |
| dma-5182 Notice Of Cooperation In Establishing Paternity And Or Medical Support | Health Benefits/NC Medicaid | Form | pdf | 13 KB | | health-benefits-nc-medicaid | form |
| dma-5183 Presumptive Eligibility Log | Health Benefits/NC Medicaid | Form | pdf | 27 KB | | health-benefits-nc-medicaid | form |
| dma-5199-ia Medicaid Renewal Request for Information Notice | Health Benefits/NC Medicaid | Form | pdf | 374 KB | | health-benefits-nc-medicaid | form |
| dma-5199sp-ia Aviso de pedido de información para la renovación de Medicaid | Health Benefits/NC Medicaid | Form | pdf | 282 KB | | health-benefits-nc-medicaid | form |
| DMA-5202 Appendix C French ANNEXE C Désignation du représentant autorisé | Health Benefits/NC Medicaid | Form | pdf | 107 KB | | health-benefits-nc-medicaid | form |
| dma-5202A-ia Health Coverage from Jobs – Appendix A | Health Benefits/NC Medicaid | Form | pdf | 677 KB | | health-benefits-nc-medicaid | form |
| dma-5202Asp-ia Apéndice A – Coberta de salud de empleos | Health Benefits/NC Medicaid | Form | pdf | 241 KB | | health-benefits-nc-medicaid | form |
| dma-5202B-ia American Indian or Alaska Native Family Member (AI/AN) – Appendix B | Health Benefits/NC Medicaid | Form | pdf | 37 KB | | health-benefits-nc-medicaid | form |
| dma-5202Bsp-ia Apéndice B – Miembro de la familia amerindio o nativo de Alaska (AI/AN) | Health Benefits/NC Medicaid | Form | pdf | 167 KB | | health-benefits-nc-medicaid | form |
| dma-5202Csp-ia Apéndice C – Designación de representante autorizado | Health Benefits/NC Medicaid | Form | pdf | 227 KB | | health-benefits-nc-medicaid | form |
| DMA-5202D Chinese 附录 D | Health Benefits/NC Medicaid | Form | pdf | 221 KB | | health-benefits-nc-medicaid | form |
| DMA-5202D French ANNEXE D REVENUS / RESSOURCES | Health Benefits/NC Medicaid | Form | pdf | 117 KB | | health-benefits-nc-medicaid | form |
| DMA-5202D Vietnamese PHỤ LỤC D | Health Benefits/NC Medicaid | Form | pdf | 162 KB | | health-benefits-nc-medicaid | form |
| DMA-5202D-ia Income/Resources – Appendix D | Health Benefits/NC Medicaid | Form | pdf | 702 KB | | health-benefits-nc-medicaid | form |
| DMA-5202DSp-ia Apéndice D – Ingresos/Recursos | Health Benefits/NC Medicaid | Form | pdf | 308 KB | | health-benefits-nc-medicaid | form |
| DMA-7010 Reports of Referrals to Law Enforcement | Health Benefits/NC Medicaid | Form | pdf | 71 KB | | health-benefits-nc-medicaid | form |
| DMA-7057 Referral For Investigation | Health Benefits/NC Medicaid | Form | pdf | 14 KB | | health-benefits-nc-medicaid | form |
| DMA-7098-ia Request and Authorization to Disclose Health Information | Health Benefits/NC Medicaid | Form | pdf | 47 KB | | health-benefits-nc-medicaid | form |
| DMA-9001 Carolina ACCESS Complaint Form Instructions | Health Benefits/NC Medicaid | Form | pdf | 42 KB | | health-benefits-nc-medicaid | form |
| DMA-9002-ia CCNC/CA – Medical Exemption Request | Health Benefits/NC Medicaid | Form | pdf | 60 KB | | health-benefits-nc-medicaid | form |
| DMA-9006 Carolina ACCESS Enrollment Form for Recipients of Medicaid and Health Choice | Health Benefits/NC Medicaid | Form | pdf | 70 KB | | health-benefits-nc-medicaid | form |
| DMA-9006-ia Carolina ACCESS Enrollment Form | Health Benefits/NC Medicaid | Form | pdf | 43 KB | | health-benefits-nc-medicaid | form |
| DMA-9007 Mail-In Application/Reenrollment Form | Health Benefits/NC Medicaid | Form | pdf | 74 KB | | health-benefits-nc-medicaid | form |
| DMA-9008-SSI Recipient without Medicare | Health Benefits/NC Medicaid | Form | pdf | 63 KB | | health-benefits-nc-medicaid | form |
| DMA-9009 SSI Recipient with Medicare | Health Benefits/NC Medicaid | Form | pdf | 49 KB | | health-benefits-nc-medicaid | form |
| DMA-9010 County Transfer | Health Benefits/NC Medicaid | Form | pdf | 53 KB | | health-benefits-nc-medicaid | form |
| DMA-9010sp ia Transferencia de condado | Health Benefits/NC Medicaid | Form | pdf | 71 KB | | health-benefits-nc-medicaid | form |
| DMA-9011 Change in Primary Doctor Practice | Health Benefits/NC Medicaid | Form | pdf | 53 KB | | health-benefits-nc-medicaid | form |
| DMA-9012 Primary Care Provider Disenrolls Recipient | Health Benefits/NC Medicaid | Form | pdf | 59 KB | | health-benefits-nc-medicaid | form |
| DMA-9013 Recipient with a Temporary Exempt | Health Benefits/NC Medicaid | Form | pdf | 65 KB | | health-benefits-nc-medicaid | form |
| DMA-9016 CCNC/CA The Benefits of Being A Member-Medicaid | Health Benefits/NC Medicaid | Form | pdf | 79 KB | | health-benefits-nc-medicaid | form |
| DMA-9016 Russian CCNC/CA: ПРЕИМУЩЕСТВА УЧАСТИЯ В ПРОГРАММЕ MEDICAID | Health Benefits/NC Medicaid | Form | pdf | 139 KB | | health-benefits-nc-medicaid | form |
| DMA-9016 Vietnamese CCNC/CA: LỢI ÍCH KHI LÀ THÀNH VIÊN MEDICAID | Health Benefits/NC Medicaid | Form | pdf | 146 KB | | health-benefits-nc-medicaid | form |
| DMA-9016sp CCNC/CA: Las Ventajas de Ser Mirembro-Medicaid | Health Benefits/NC Medicaid | Form | pdf | 16 KB | | health-benefits-nc-medicaid | form |
| DMA-9017 CCNC/CA: The Benefits of Being a Member-NCHC | Health Benefits/NC Medicaid | Form | pdf | 118 KB | | health-benefits-nc-medicaid | form |
| DMA-9017sp CCNC/CA, Los Beneficios de Ser Miembro-NCHC | Health Benefits/NC Medicaid | Form | pdf | 123 KB | | health-benefits-nc-medicaid | form |
| DMA-9050-ia Nursing Home Notice of Transfer/Discharge | Health Benefits/NC Medicaid | Form | pdf | 77 KB | | health-benefits-nc-medicaid | form |
| DMA-9051-ia Nursing Home Hearing Request Form | Health Benefits/NC Medicaid | Form | pdf | 69 KB | | health-benefits-nc-medicaid | form |
| DMA-9052-ia Adult Care Home Notice of Transfer/Discharge | Health Benefits/NC Medicaid | Form | pdf | 85 KB | | health-benefits-nc-medicaid | form |
| DMA-9053-ia Adult Care Home Hearing Request Form | Health Benefits/NC Medicaid | Form | pdf | 61 KB | | health-benefits-nc-medicaid | form |
| DSS-8110 Change Term Adequate Vietnamese Quyền Lợi Trợ Cấp Y Tế Của Quý Vị Sắp | Health Benefits/NC Medicaid | Form | pdf | 194 KB | | health-benefits-nc-medicaid | form |
| DSS-8110 CHANGE/TERMINATION ADEQUATE | Health Benefits/NC Medicaid | Form | pdf | 133 KB | | health-benefits-nc-medicaid | form |
| DSS-8110 CHANGE/TERMINATION TIMELY | Health Benefits/NC Medicaid | Form | pdf | 121 KB | | health-benefits-nc-medicaid | form |
| DSS-8110 CHANGE/TERMINATION TIMELY – French | Forms in Other Languages, Health Benefits/NC Medicaid | Form | pdf | 150 KB | | forms-in-other-languages health-benefits-nc-medicaid social-services | form |
| DSS-8110 Conti Russian Ваши льготы на медицинское обслуживание сохраняются | Health Benefits/NC Medicaid | Form | pdf | 172 KB | | health-benefits-nc-medicaid | form |
| DSS-8110 CONTINUING | Health Benefits/NC Medicaid | Form | pdf | 107 KB | | health-benefits-nc-medicaid | form |
| DSS-8110 CONTINUING Chinese 您的医疗补助福利将继续发放 | Health Benefits/NC Medicaid | Form | pdf | 182 KB | | health-benefits-nc-medicaid | form |
| DSS-8110 Desk Reference Tool | Family and Children's Medicaid, Health Benefits/NC Medicaid | Administrative Letter | pdf | 359 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | administrative-letter |
| DSS-8110 Transitional | Health Benefits/NC Medicaid | Form | pdf | 177 KB | | health-benefits-nc-medicaid | form |
| DSS-8110sp CHANGE/TERMINATION ADEQUATE | Health Benefits/NC Medicaid | Form | pdf | 105 KB | | health-benefits-nc-medicaid | form |
| DSS-8110sp CHANGE/TERMINATION TIMELY | Health Benefits/NC Medicaid | Form | pdf | 91 KB | | health-benefits-nc-medicaid | form |
| DSS-8110sp CONTINUING | Health Benefits/NC Medicaid | Form | pdf | 134 KB | | health-benefits-nc-medicaid | form |
| DSS-8110sp Transitional | Health Benefits/NC Medicaid | Form | pdf | 184 KB | | health-benefits-nc-medicaid | form |
| EIS-1105 STATE DATA EXCHANGE (SDX) | Health Benefits/NC Medicaid, Medicaid Eligibility Information System (EIS) | Manual | pdf | 293 KB | | health-benefits-nc-medicaid medicaid-eligibility-information-system-eis | manual |
| EIS-4000 CODES APPENDIX B – MEDICAID CODES | Health Benefits/NC Medicaid, Medicaid Eligibility Information System (EIS) | Manual | pdf | 342 KB | | health-benefits-nc-medicaid medicaid-eligibility-information-system-eis | manual |
| EIS-4000 CODES APPENDIX E – TRANSITIONAL CODES | Health Benefits/NC Medicaid, Medicaid Eligibility Information System (EIS) | Manual | pdf | 72 KB | | health-benefits-nc-medicaid medicaid-eligibility-information-system-eis | manual |
| EIS-4000 CODES APPENDIX TABLE OF CONTENTS | Health Benefits/NC Medicaid, Medicaid Eligibility Information System (EIS) | Manual | pdf | 285 KB | | health-benefits-nc-medicaid medicaid-eligibility-information-system-eis | manual |
| FAMILY AND CHILDREN’S MEDICAID TABLE OF CONTENTS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 122 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA- 200 Definitions | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 160 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA- 300 Confidentiality | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 111 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA- 400 Introduction to Medicaid | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 32 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA- 500 Classification | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 112 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-1000 SSI MEDICAID AUTOMATED PROCESS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 285 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-1100 SSI Medicaid-County DSS Responsibility | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 240 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2000 NON-SSI ELIGIBILITY REGULATIONS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 47 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2100 CATEGORICALLY NEEDY-NO MONEY PAYMENT | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 21 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2110 PASS-ALONG | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 402 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2120 MEDICALLY NEEDY REGULATIONS{ XE “MEDICALLY NEEDY REGULATIONS” } | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 23 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2130 QUALIFIED MEDICARE BENEFICIARIES – Q | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 169 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2140 QUALIFIED MEDICARE BENEFICIARIES – B | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 171 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2150 MEDICAID-WORKING DISABLED | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 24 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2160 QUALIFIED INDIVIDUAL – MQB-E | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 170 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2170 FAMILY PLANNING PROGRAM | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 82 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2180 HEALTH COVERAGE FOR WORKERS WITH DISABILITIES | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 326 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2180 HEALTH COVERAGE FOR WORKERS WITH DISABILITIES – 2019 HCWD Premiums | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 122 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2220 STATE RESIDENCY | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 187 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2221 COUNTY RESIDENCE | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 85 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2230 FINANCIAL RESOURCES | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 856 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2231 COMMUNITY SPOUSE RESOURCE PROTECTION | Adult Medicaid | Policy | pdf | 214 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2240 TRANSFER OF ASSETS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 751 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2242 HOME EQUITY VALUE & ELIGIBILITY FOR INSTITUTIONAL SERVICES | Adult Medicaid | Policy | pdf | 112 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2245 UNDUE HARDSHIP WAIVER FOR TRANSFER OF ASSETS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 93 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2250 INCOME | Adult Medicaid | Policy | pdf | 607 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2251 REASONABLE COMPATIBILITY | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 154 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2251 Reasonable Compatibility Calculator-20% Effective January 16, 2023 | Adult Medicaid, Health Benefits/NC Medicaid | Policy | xlsx | 12 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2252 2019 NON-MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 134 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2252 2020 NON-MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 130 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2252 2021 NON-MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 131 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2252 2022 NON-MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 132 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2252 2023 NON-MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 147 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2252 NON-MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 147 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2252, NON- MAGI MEDICAID INCOME/RESERVE LIMITS | Adult Medicaid | | pdf | 149 KB | | adult-medicaid health-benefits-nc-medicaid | |
| MA-2260 FINANCIAL ELIGIBILITY REGULATIONS-PLA | Adult Medicaid | Policy | pdf | 213 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2261 1/3 REDUCTION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 20 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2262 SPONSOR DEEMING | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 137 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2270 LONG TERM CARE NEED AND BUDGETING | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 533 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2270 LTC Evidence Changes Prior to Eligibility Determination Listserv | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 58 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2270 Prepaid Health Plan Notification of Nursing Facility Level of Care Form | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 128 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2275 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 277 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2280 COMMUNITY ALTERNATIVES PROGRAM (CAP) | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 187 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2282 INNOVATIONS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 189 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2283 TRAUMATIC BRAIN INJURY (TBI) | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 171 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2284 MONEY FOLLOWS THE PERSON | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 203 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2285 ESTATE RECOVERY | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 572 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2290 MANAGED CARE | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 234 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2295 DISCOURAGEMENT | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 74 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2296 INQUIRY | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 154 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2300 APPLICATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 378 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2301 POST ELIGIBILITY VERIFICATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 432 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2302 OUTSTATIONS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 145 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2305 EVALUATING COUNTY/DDS PERFORMANCE | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 199 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2306 APPLICATION PROCESSING – CORRECTIVE ACTION PROCEDURES | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 189 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2309 LIS APPLICATION FOR MEDICAID | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 48 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2310 TAKING THE LIS APPLICATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 189 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2311 LIS PROCESSING AND CASE MAINTENANCE | Adult Medicaid | Policy | pdf | 216 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2312 MEDICARE PRESCRIPTION DRUG BENEFIT | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 117 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2320 RECERTIFICATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 300 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2321 MEDICALLY NEEDY RECERTIFICATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 294 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2340 CHANGE IN SITUATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 227 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2350 CERTIFICATION AND AUTHORIZATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 76 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2352 CHANGE IN CIRCUMSTANCE, TERMINATIONS, AND REOPENING | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 246 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2355 MAABD/MQB PROGRAM TRANSFERS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 27 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2360 MEDICAID DEDUCTIBLE | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 294 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2375 CHILD SUPPORT | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 153 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2380 MEDICAID IDENTIFICATION CARD | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 74 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2395 CORRECTIVE ACTION AND RESPONSIBILITY FOR ERRORS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 166 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2395 Medicaid Procedures for Requesting Corrections – DSS Support Unit | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 166 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2400 Additions/Terminations/Changes to Third Party Insurance Listserv (August 10, 2020) | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 124 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2400 THIRD PARTY RECOVERY | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 124 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2410 MEDICARE ENROLLMENT & BUY-IN | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 247 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2420 DHB -DSS 8110 DESK REFERENCE TOOL | Adult Medicaid, Health Benefits/NC Medicaid | Procedure | pdf | 681 KB | | adult-medicaid health-benefits-nc-medicaid | procedure |
| MA-2420 NOTICE AND HEARINGS PROCESS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 333 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2425 COMMUNITY CARE OF NORTH CAROLINA (CCNC)/CAROLINA ACCESS (CA) | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 181 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2430 AUTOMATED INQUIRY AND MATCH PROCEDURES | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 249 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2440 AUTOMATED SOLQ PROCEDURES | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 34 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2450 ENUMERATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 166 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2500 AGE/NAME/MARITAL STATUS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 175 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2504 ALIEN REQUIREMENTS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 452 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2505 CITIZENSHIP/IDENTITY SSA DATA MATCH | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 93 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2506 US CITIZENSHIP REQUIREMENTS | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 256 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2507 TRIBAL MEMBERSHIP AND AMERICAN INDIAN HEALTH SERVICE | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 185 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2510 LIVING ARRANGEMENT | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 341 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2525 DISABILITY | Adult Medicaid | Policy | pdf | 296 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2531 BLINDNESS – MAB | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 27 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2900 BENEFICAIRY FRAUD AND ABUSE POLICY AND PROCEDURES | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 1 MB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2905- MEDICAID COVERED SERVICES | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 555 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2910 – NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT) | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 649 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2930 2023-2024 County Internal Inspection Schedule | Adult Medicaid, Health Benefits/NC Medicaid | Policy | xlsx | 13 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2930 SECURITY OF INTERNAL REVENUE SERVICE AND SOCIAL SECURITY ADMINISTRATION INFORMATION | Adult Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 225 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-2940 SOCIAL SECURITY COST-OF-LIVING ADJUSTMENT (COLA) | Adult Medicaid | Policy | pdf | 146 KB | | adult-medicaid health-benefits-nc-medicaid | policy |
| MA-3100 INTRODUCTION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 382 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3110 DEFINITIONS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 273 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3120 SSI MEDICAID | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 211 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3185 DISCOURAGEMENT | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 117 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3190 INQUIRY | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 133 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3200 APPLICATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 388 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3205 POST ELIGIBILITY VERIFICATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 324 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3207 OUTSTATIONS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 125 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3217 EVALUATING COUNTY/DDS PERFORMANCE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 227 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3225 APPLICATION PROCESSING – CORRECTIVE ACTION PROCEDURES | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 198 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3230 AUTO NEWBORN | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 235 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3231 ADOPTION MEDICAL ASSISTANCE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 142 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3232 FOSTER CARE MEDICAL ASSISTANCE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 149 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3233-A FORMER FOSTER CARE CHILDREN (MFC) NORTH CAROLINA | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 172 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3233-B FORMER FOSTER CARE CHILDREN (MFC) ANY STATE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 187 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3234 EXPANDED FOSTER CARE PROGRAM (EFCP) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 37 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3235 CARETAKER RELATIVES/KINSHIP | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 181 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3236 MAGI ADULT MEDICAID EXPANSION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 215 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3240 PREGNANT WOMAN COVERAGE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 263 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3245 PRESUMPTIVE ELIGIBILITY FOR PREGNANT WOMEN | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 124 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3246 HOSPITAL PRESUMPTIVE ELIGIBILITY | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 176 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3250 BREAST AND CERVICAL CANCER MEDICAID (BCCM) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 168 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3260 COMMUNITY ALTERNATIVES PROGRAM (CAP) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 185 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3262 MONEY FOLLOWS THE PERSON | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 216 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3263 MANAGED CARE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 216 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3265 FAMILY PLANNING PROGRAM | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 142 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3270 PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 129 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3300 INCOME | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 490 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3305 MAF, MIC, HSF BUDGETING | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 266 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3306 DESK TOOL REFERENCE – CONSTRUCTING THE MAGI HOUSEHOLD | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 168 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3306 DESK TOOL REFERENCE – MAGI COUNTING INCOME CHART | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 103 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3306 DESK TOOL REFERENCE – MAGI HOUSEHOLD COMPOSITION CHART | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 115 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3306 MODIFIED ADJUSTED GROSS INCOME (MAGI) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 422 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3310 REASONABLE COMPATIBILITY | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 390 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3310 REASONABLE COMPATIBILITY CALCULATOR-20% | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | xlsx | 12 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3313 SPONSOR DEEMING | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 140 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3315 MEDICAID DEDUCTIBLE | Family and Children's Medicaid | Policy | pdf | 298 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | policy |
| MA-3320 RESOURCES | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 149 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3321 2018 MAGI MEDICAID/NCHC INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | doc | 126 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3321 2019 MAGI MEDICAID/NCHC INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | doc | 110 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3321 2020 MAGI MEDICAID/NCHC INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 121 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3321 2021 MAGI MEDICAID/NCHC INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 122 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3321 2022 MAGI MEDICIAD/NCHC INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 122 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3321 2023 MAGI MEDICAID INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 224 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3321 2023 MAGI MEDICAID INCOME LIMITS WITH MXP | Family and Children's Medicaid, Health Benefits/NC Medicaid | | pdf | 107 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | |
| MA-3321 MAGI MEDICAID INCOME LIMITS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | | 224 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3322 COMMUNITY SPOUSE RESOURCE PROTECTION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 147 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3325 LONG TERM CARE BUDGETING | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 116 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3326 ESTATE RECOVERY | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 262 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3330 ALIEN REQUIREMENTS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 446 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3331 CITIZENSHIP/IDENTITY SSA DATA MATCH | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 93 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3332 US CITIZENSHIP REQUIREMENTS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 260 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3333 TRIBAL MEMBERSHIP AND AMERICAN INDIAN HEALTH SERVICE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 186 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3335 STATE RESIDENCY | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 190 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3340 COUNTY RESIDENCE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 112 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3345 AGE/NAME/MARITAL STATUS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Policy | pdf | 177 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | policy |
| MA-3355 ENUMERATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 170 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3360 LIVING ARRANGEMENT | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 404 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3365 CHILD SUPPORT | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 157 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3400 FOUR MONTHS TRANSITIONAL MEDICAID | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 83 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3405 TWELVE MONTHS TRANSITIONAL MEDICAID | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 187 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3410 CHANGE IN CIRCUMSTANCE, TERMINATIONS, AND REOPENING | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 249 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3415 CLASSIFICATION AND EVALUATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 44 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3420 MEDICALLY NEEDY RECERTIFICATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 321 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3421 MAGI RECERTIFICATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 422 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3425 CERTIFICATION AND AUTHORIZATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 75 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3430 NOTICE AND HEARINGS PROCESS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 338 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3435 COMMUNITY CARE OF NORTH CAROLINA (CCNC)/CAROLINA ACCESS (CA) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 194 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3500 CONFIDENTIALITY | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 109 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3505 MEDICAID IDENTIFICATION CARD | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 74 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3510 THIRD PARTY RECOVERY | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 120 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3515 AUTOMATED INQUIRY AND MATCH PROCEDURES | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 251 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3520 AUTOMATED SOLQ PROCEDURES | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 22 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3525 MEDICARE ENROLLMENT & BUY-IN | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 233 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3530 CORRECTIVE ACTION AND RESPONSIBILITY FOR ERRORS | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 166 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3535 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 2 MB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3540 MEDICAID COVERED SERVICES | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 554 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3550 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT) | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 610 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3560 2023 – 2024 COUNTY INTERNAL INSPECTION SCHEDULE | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | xlsx | 13 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3560 SECURITY OF INTERNAL REVENUE SERVICE AND SOCIAL SECURITY ADMINISTRATION INFORMATION | Family and Children's Medicaid, Health Benefits/NC Medicaid | Manual | pdf | 247 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | manual |
| MA-3570 SOCIAL SECURITY COST-OF-LIVING ADJUSTMENT (COLA) | Family and Children's Medicaid | Policy | pdf | 149 KB | | family-and-childrens-medicaid health-benefits-nc-medicaid | policy |
| X/PTR – REPORT DISTRIBUTION SYSTEM | Health Benefits/NC Medicaid, Medicaid Eligibility Information System (EIS) | Manual | pdf | 148 KB | | health-benefits-nc-medicaid medicaid-eligibility-information-system-eis | manual |
