NC Medicaid Rules Have Changed

MEDICAID CANCELED? Click here for information on what to do.

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NC Medicaid Rules Have Changed

Everyone must renew their coverage this year.


Your local department of social services (DSS) has begun checking to see if you are still eligible for Medicaid. DSS will cancel Medicaid for those who do not return the information needed to determine their eligibility. Follow the steps below to make sure your information is up to date.

1. Update your contact information.

Visit epass.nc.gov or call your local DSS to make sure they have your current mailing address, phone number, email, and other contact information. It only takes 10 minutes to update your information online!

Watch the video below to see how to set up an ePASS account.

2. Look out for notices from DSS.

Medicaid is trying to reach you. Check for official mail, email, or texts with instructions on when and how to renew coverage or benefits. Your notice may look like this or like this.

If you think you received a letter that was not from your local DSS and it may be a scam, contact your local DSS. Find their phone number here.

3. Reply as soon as possible.

Respond right away with updated information. Submit forms by the due date listed on your notice.

Was Your Medicaid Canceled?

You have the right to appeal.

You have 60 days from the date you receive a notice of cancellation or reduction of coverage to ask for an appeal. If you think your Medicaid was wrongfully reduced or canceled, call 1-800-936-4971 or email hawkinsinfo@charlottelegaladvocacy.org.

Free legal assistance may be available from the following organizations:

 

Legal Aid of North Carolina
866-219-5262
Counties served: All except for Mecklenburg
 

Charlotte Center for Legal Advocacy
English: 800-438-1254
Spanish: 800-247-1931
County served: Mecklenburg
 

Pisgah Legal Services
800-489-6144
Counties served: Avery, Buncombe, Henderson, Jackson, Macon, Madison, Mitchell, Polk, Rutherford, Transylvania, and Yancey

You may qualify for Medicare or Marketplace coverage.


If you are no longer eligible for Medicaid, you may be eligible to enroll in Medicare or Marketplace coverage during a special enrollment period. Get help enrolling in the Marketplace or Medicare by contacting the following:

You may qualify for Family Planning Medicaid and be automatically enrolled in Medicaid expansion, if eligible.

In some cases, enrollees will lose coverage but qualify for a different Medicaid program called Family Planning Medicaid, which is a limited benefit plan. Although this is a limited benefit program, many people in Family Planning Medicaid will become eligible for comprehensive benefits after North Carolina implements Medicaid expansion. By being in the Family Planning Medicaid plan now, people who are eligible will automatically be enrolled in Medicaid expansion once the program goes live on December 1, 2023.

It is important that you do not cancel Family Planning coverage to ensure you are auto-enrolled into Medicaid expansion, if eligible, on December 1, 2023.

You Have Rights

Under a federal lawsuit, you have the right to:

  • Reach DSS by phone during the redetermination process. This includes the right to leave a message instead of remaining on hold and to have your call returned within a reasonable time.
  • Request and receive help from DSS to obtain the information needed to redetermine your eligibility.
  • Have DSS accept your detailed statement about your income, assets, and most other facts needed to verify your eligibility, in writing or verbally, without providing supporting documents.
  • Not be asked to verify information DSS can obtain through electronic sources or to verify information that is not needed to redetermine your eligibility.
  • Have your Medicaid eligibility considered under all categories, including an alleged disability, before your Medicaid can be terminated or reduced.
  • Receive written notice that tells you what action has been taken and the reason it has been taken before your Medicaid is stopped or reduced.
  • Have your Medicaid reopened by DSS if it was terminated due to failure to provide information and you can provide the missing information within 90 days of when your Medicaid was terminated.

If you think your rights were violated by DSS, call 1-800-936-4971 or email hawkinsinfo@charlottelegaladvocacy.org.

 

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