ADULT ASSISTANCE |
| |
|
WHAT IS MEDICAID FOR THE AGED, BLIND AND DISABLED?
|
|
Medicaid is a program that pays medical bills for
eligible adults who cannot afford health care. The program costs are paid by federal,
state, and county taxes. It also pays prescriptions for eligible adults without
Medicare. |
Back To Top
|
WHAT ARE THE BASIC ELIGIBILITY CRITERIA FOR ADULTS?
|
| Program Name |
Income |
Group Covered |
Benefits |
Reserve |
Medicaid-Aged, Blind,
Disabled
(Categorically Needy) |
$903(1)
$1215(2) |
Supplemental Social
Security (SSI) recipient or under 100% federal poverty level |
All needed medical care
Limit 9 prescriptions |
$2000(1)
$3000(2) |
Medicaid for Qualified
Beneficiaries
(MQB-Program Q) |
$903(1)(MQBQ)
$1215(2)(MQBQ) |
Couple who Get Medicare |
Pays Medicare premiums,
co-payments, and deductible
(MQBQ) |
$4000(1)
$6000(2) |
Medicaid for Qualified
Beneficiaries
(MQB-Program B)
(MQB-Program E)
(MQB-Program E) |
$1083(1)(MQBB)
$1457(2)(MQBB)
$1219(1)(MQBE)
$1640(2)(MQBE) |
Couple who get Medicare
Couple
who get Medicare |
Pays Medicare premiums
(MQBB)
Pays Medicare Premiums
(MQBE) |
$4000(1)
$6000(2)
$4000(1)
$6000(2) |
| Medicaid-Aged, Blind,
Disabled (Medically needy) |
$242(1)
$317(2)
(Deductible may apply) |
Over 65 or disabled through
Social Security |
All needed medical care;
Prescription coverage varies |
$2000(1)
$3000(2) |
| Medicaid-Long Term Care |
All income except $30/mo
goes to Nursing Home |
Certified by doctor and
approved by EDS (Electronic Data Systems) |
All needed medical care |
$2000 per person |
| Medicaid-CAP |
$242 for one person |
Certified by doctor,
approved by EDS (Electronic Data Systems) |
All needed medical care;
Prescription coverage varies |
$2000 per person |
|
|
Back To Top
|
|
LONG TERM CARE (Nursing Home) |
|
-> Link to Catawba County Long Term Care Facilities
|
Medicaid will pay for
medically necessary nursing home care for a Medicaid eligible individual who is either a
patient in a nursing home or in an Intermediate Care facility for the Mentally Retarded.
- Medical need for the patient to be in a nursing home bed must be approved in
Raleigh.
- If an applicant/recipient, his spouse, or legal representative gives away or sells
assets belonging to the applicant/recipient for less than current market value, he may not
be eligible for payment of cost of care in the nursing home
- There are limits on the amount and type of real and personal property a person may
have. If the applicant has a spouse, it is possible for up to one-half of the assets to be
protected for the spouse at home.
- The recipient must use his/her income to help pay for nursing home care. Each
recipient keeps $30 per month for his personal needs; an additional amount may be set
aside for the spouse at home.
|
|
Back To Top |
| SPECIAL ASSISTANCE (Adult Care Homes) |
|
This program provides
financial assistance to those who are in a home for the aged and disabled, family care
home, group home, or an area-operated mental health home.
The individual must be at least 65 years of age, or disabled by Social Security
standards, or receiving SSI (Supplemental Social Security).The individual's income must be
used to help pay the cost of care; $66 is set aside for personal needs. |
|
Back To Top |
|
SPECIAL ASSISTANCE IN-HOME |
|
This program is for Medicaid
eligible individuals with incomes at or below 100% of the federal proverty level, who meet
all other eligibility criteria for Special Assistance, and are financially eligible for
Special Assistance payments in in-home living arrangements. The current federal poverty
level is $903 and increases each year in April. This income level (need standard) is lower
than the income level for individuals receiving Special Assistance in adult care homes. |
|
Back To Top |
|
HEALTH COVERAGE FOR WORKERS WITH DISABILITIES (HCWD) |
|
This Medicaid program covers blind or disabled workers age 16 through 64 with incomes equal to or less than
150% of the federal poverty level. This would be $1354 for a single individual and $1822 for a couple. This
program provides an incentive for disabled persons to go to work or increase their hours of work while
protecting their Medicaid eligiblity. |
|
Back To Top |
|
FREQUENTLY ASKED QUESTIONS |
|
1. How is Medicaid
different from Medicare?
Medicare is health insurance for people over 65 and some disabled individuals.
Administered by the federal government through the Social Security Administration, it is
available without regard to the individual's assets or income level.
Medicare Link (http://www.Medicare.gov)
Medicaid is a medical assistance program for low-income people. Run by the state, it is
based on federal and state regulations. The individual must meet income and asset limits,
and be aged, blind, or disabled.
Medicaid Link (http://www.cms.hhs.gov)
2. How do I apply?
Our office is located behind Catawba Valley Medical Center, at 3030 11th Ave. Dr. SE.
Office phone number is (828) 695-5600. Office hours are 8 a.m. until 5 p.m.
Please bring the individual's Social Security number, life insurance policies, recent
bank statements, medical bills, proof of residency, and birth certificate.
3. How do I find a doctor who accepts Medicaid?
Click here for a list of Medicaid Providers
|
Back To Top
Your
Questions and Comments Are Welcome
Revised 8/07/2006
|