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n.c. health choice for children

North Carolina Health Choice is a health insurance program that serves children from working families. It provides full medical insurance coverage to low-income children who are not eligible for Medicaid but whose family income is less than 200 % of the federal poverty standard but cannot afford private health insurance. These families earn too much money to qualify for Medicaid, but cannot afford private health insurance. The families must meet specific guidelines and the children must be under age 19. The program is free to most. Some families, with higher incomes, must pay an annual premium, which can never exceed $100 (regardless of the number of children enrolled from the family). There is no limit on resources. The coverage is similar to that of Medicaid. Eligible children receive a card which is valid for one year (unless they move out of state or become insured through another source). North Carolina has limited funds available for N.C. Health Choice. Because of the capped funding, a waiting list may be instituted at anytime when the program reaches or exceeds it s funding limits. During an enrollment freeze, families may still apply for assistance, however, children who are found eligible for NCHC are added to a list to await enrollment when funds become available.

NC Health Choice for Children provides health coverage for uninsured children (under 19 years old) whose families do not have health insurance benefits and who do not qualify for Medicaid. Income guidelines apply and there is an enrollment fee if countable income equals or exceeds set amounts. As shown in the table below, a family of four earning less than $3,067 gross per month can receive coverage which includes medical, dental, vision and hearing care as well as counseling, therapies and mental health. Blue Cross/Blue Shield of N.C. administers the program, and the cost is paid by federal and state funding.

Income Guidelines
Family Size
Monthly Income
(before taxes)
2
$2,020
3
$2,544
4
$3,067
5
$3,590


note - effective 4/01/03 - 03/31/04

Step Parent/Grandparent Income is not counted.

Deductions from income:

  • daycare for child or incapacitated adult
  • child support being paid for a child outside of the home
  • income of a step-parent is not counted.

You can download an NCHC application and find out more information about the plan at the NC Division of Medical Assistance website.

Health Choice Services Include:

  • doctor visits for sick children
  • well child check-ups
  • eye exams and glasses
  • hearing exams and hearing aids
  • prescriptions
  • hospital coverage
  • dental care
  • mental health
  • counseling
  • and more

Appointment Procedure
Apply at DSS, use mail-in Medicaid/Health Choice Applications, applications can be mailed in.

What to bring with you
Income verfification.

How are services paid for?
Federal and State funds.

Forms
NC Health Choice Applications
English I Espanol

*You will need Adobe Acrobat Reader to view the forms. You can dowload it below:

Copyright 2005 - All rights reserved - Swain County DSS, North Carolina

DISCLAIMER: The information contained in the following pages was considered correct at the time of publication. Swain County DSS reserves the right to make changes at any time and without notice, and assumes no liability for damages incurred directly or indirectly as a result of errors, omissions or discrepancies.