Medicaid
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Medicaid
is a program that helps pay the cost of health care services for people
with low incomes. Although many of the guidelines for Medicaid are set
at the federal level by the Health
Care Financing Administration, states have some flexibility in setting
eligibility standards and designating covered services. In North Carolina,
the Division of Medical Assistance
(DMA) is the agency responsible for establishing state policies and rules
for administration of Medicaid. At the local level, county departments
of social services process applications for Medicaid and make eligibility
determinations. Financial eligibility for Medicaid is based on the amount
of an older person's income and assets. For information about where to
get help with concerns about enrollment or benefits, see complaints.
The
North
Carolina Cooperative Extension Service also has useful information
on the rules for Medicaid eligibility for nursing home care.
Medicaid is a significant source of funding for nursing home care, medical care, and prescription drugs. Medicaid's Community Alternatives Program for Disabled Adults (CAP/DA) has also become an important resource for disabled adults enabling them to remain living in the community rather than a nursing home. A federal waiver granted to DMA allows this program to provide home and community-based services to individuals who would otherwise require nursing facility care. The total cost of the home care must be less than the comparable Medicaid cost for institutional care. Each client has a local case manager who arranges, coordinates, and monitors the home and community-based services as well as other aspects of the individual's home care. Possible services include: adult day health care, supplies (for example, disposable adult diapers, oral nutritional supplements), home-delivered meals, home mobility aids (for example, wheelchair ramps, grab bars), in-home aide services for personal care, in-home and institutional respite, and telephone alert. For further information about CAP/DA, contact the DMA CAP/DA Unit (919) 733-3945. |
Date last modified: March 5, 2003