NC Health Choice

Q.  What is North Carolina’s Children’s Health Insurance Program? 

A.  As of October 1998, families who make too much money to qualify for Medicaid but too little to afford rising health insurance premiums are able to get free or reduced price comprehensive health care for their children.  “NC Health Choice for Children,” is the same as coverage provided for the children of state employees and teachers, plus vision, hearing and dental benefits.

Q.  What does it cost?

A.  There are certain out of pocket costs. Under federal law, these can never exceed 5% of the family’s income. For those at the higher end of the income scale, there is an enrollment fee of $50 for one child or $100 for two or more children. There are also copayments of $20 for nonemergency emergency room use, $5 per physician or dental visit.   For prescription drugs there are copayments of $1 for a generic drug, $1 for a brand drug for which no generic is available, and $10.00 for brand drug for which there is a generic available.

Families at this income level are also allowed child care and business deductions. They have no enrollment fees.

Q: What does NC Health Choice Cover?

A: Please click here for a link to the NCHC Handbook.

Q.  How do you apply for NCHC? 

A.  Applications for this program are available at Alamance County Department of Social Services and online.  Click the following links to print an application:

North Carolina Health Choice Application-English
North Carolina Health Choice Application-Spanish

It is a two-page application form which can be mailed to our office located at 319 N. Graham-Hopedale Rd, Suite C, Burlington, NC 27217.   You can drop the application off at our office location.  To expedite the process, please come to Department of Social Services for a face to face interview. The form plus any required enrollment fee will begin the application process.  Income verification and enrollment fee (if required) are needed to approve the application.  Each application will first be looked at to see if the child is eligible for Medicaid and, if not, then looked at to see if the child is eligible for the NCHC. If the child is found to be eligible, the application will be processed and the parents will receive a health insurance card, a benefits booklet and instructions in the mail. Once parents are notified, the child is eligible to receive care.

Note: Unlike Medicaid, this program is limited by the amount of funds which are available. Therefore, it is open only to children on a first come, first served basis. Once the program is full, a waiting list will be taken, so it is in the best interest of the child to enroll as soon as it is possible. The state does feel that there are enough funds to cover all available children, however, there is no exact count of the numbers of uninsured children in the state. Every effort will be made to notify families through various media that this program exists and who is eligible.

Q.  How do I let my doctor know that I have North Carolina Health Choice?

A.  When you are approved for North Carolina Health Choice, you will receive one (1) Identification (ID) card in the mail. You must always show your ID card each time you go to the doctor, hospital, pharmacy, or any other medical provider. Your ID card is proof that you have coverage. It is very important to keep up with your ID card! It is your health insurance card. If you do not show your card to the medical provider, they will not know you are covered by NCHC and you may become responsible for paying the full cost of the medical bill or prescription. Each child covered by NCHC receives his or her own ID card.

Q.  What do I do if I lose my child’s North Carolina Health Choice ID card?

A.  In the event you lose your child’s North Carolina Health Choice ID card, you must call Customer Services at 1-800-422-4658 to request another one. The Department of Social Services cannot replace a NCHC ID card.

Q.  How long can I receive North Carolina Health Choice after I am approved?

A.  You may receive NCHC as long as you continue to meet the requirements. Your caseworker will review your situation every 12 months.  You must report all changes in situation to your caseworker within 10 days. You cannot receive North Carolina Health Choice if you begin receiving coverage through another health insurance program.

Q.  Why health insurance is important? 

A.  When working families cannot afford health care for their children, the consequences can be dire. Babies may not get the checkups that make sure they are growing healthy and strong. Families may wait until a child is very sick before seeking medical help, sometimes getting help only in an emergency. Untreated illnesses can have long-lasting consequences, such as hearing loss caused by ear infections.