Thousands in NC could lose full Medicaid coverage Thursday. What to know

Thousands of North Carolina Medicaid recipients could lose full health coverage starting Thursday as new federal eligibility rules for noncitizens take effect.

For those affected, that could mean losing Medicaid coverage for regular doctor visits, prescriptions, dental care and mental health treatment.

Here’s what to know.

What is changing?

The immigration statuses that qualify for Medicaid are narrowing Thursday.

For years, noncitizens including refugees, people granted asylum, people granted humanitarian parole and some trafficking survivors have been eligible for Medicaid.

Starting Thursday, green card holders can remain eligible, although most face a five-year waiting period. Cuban and Haitian entrants and citizens of certain Pacific island nations can also qualify.

Children under 19 and people who are pregnant or gave birth within the past 12 months can also remain eligible if they are lawfully residing in the United States. They must still meet Medicaid's other eligibility requirements, including age and income rules.

The state, which administers the federal health care program, is required to follow the new eligibility rules.

According to the North Carolina Department of Health and Human Services, people with the following immigration statuses will lose coverage under the new rules:

• American Indians born in Canada or outside the U.S., including federally recognized tribal members who are not U.S. citizens
• Battered noncitizens, including spouses, parents and children
• Lawfully residing veterans or active-duty service members, including certain family members
• Noncitizens with Iraqi or Afghan special immigrant visas, including spouses and children
• Hmong, Mien or Highland Laotian noncitizens, including spouses and children
• Applicants for permanent residence, asylum or temporary protected status

Immigration status is only one part of eligibility. Someone must still meet Medicaid's other requirements, including income rules.

For most adults ages 19 to 64, a single person can earn up to $1,835 a month before taxes and potentially qualify for Medicaid. The limit increases with household size to $2,399 for a household of two, $3,141 for three and $3,795 for four, according to DHHS.

What happens if I lose coverage?

While many categories of immigrants are losing full Medicaid benefits, some people may still qualify for Emergency Medicaid, which helps pay for qualifying emergency hospital care.

Emergency Medicaid is limited to medical emergencies and does not replace full coverage for routine care, according to DHHS.

People who lose Medicaid may be able to get insurance through the federal Health Insurance Marketplace. Federally qualified health centers also provide lower-cost care to some people without insurance.

What if my child qualifies but I don't?

A parent's immigration status does not prevent an eligible child from receiving Medicaid.

Parents and guardians can apply for Medicaid on behalf of eligible family members even if they do not qualify themselves, according to DHHS. Parents only have to provide immigration information or Social Security numbers for family members seeking coverage.

How will I know if I'm affected?

People losing Medicaid coverage under the new eligibility rules will receive a letter explaining why and how to appeal, according to DHHS.

Recipients can check with their local department of social services to make sure their current contact information is on file. People who disagree with a coverage decision generally have 60 days from the date of the letter to appeal.

Free help is available through the NC Medicaid Ombudsman at 1-877-201-3750.

Are more Medicaid changes coming?

The rules taking effect Thursday are separate from broader federal Medicaid changes that begin Jan. 1.

Starting Jan. 1, many adults ages 19 to 64 will have to work, attend school, volunteer or participate in another qualifying activity for at least 80 hours a month to keep Medicaid coverage, unless they are exempt. People can also meet the requirement if their household earns at least $580 a month, according to DHHS.

Many recipients will also have to renew their eligibility every six months instead of once a year.