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Children's Health Insurance Program (North Carolina)

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North Carolina Health Choice (NCHC)

NCHC, established in 1998, provides health coverage to uninsured children of North Carolina under the age of 21 and whose family income meets the specified guidelines.

Eligibility Requirements
To qualify for the North Carolina Health Choice program, a child must be a resident of North Carolina, U.S. citizen and a qualified immigrant. The family income should meet the income guidelines that must be below 200% of the federal poverty level.

Waiting Periods
Waiting periods are not imposed on most applicants. Contact NCHC for additional information pertaining to possible waiting periods.

Covered Services and Benefits
NCHC provides medical coverage for:

  • Physician and clinic services
  • Laboratory and radiology services
  • Surgical services
  • Prescription drugs
  • Dental services
  • Vision
  • Hearing
  • Durable medical equipment and supplies such as wheelchairs
  • Physical therapy, occupational therapy and therapy for individuals with speech, hearing and language disorders
  • Hospice care
  • Home health care (limited)
  • Inpatient mental health services
  • Outpatient mental health services
  • Inpatient substance abuse treatment and outpatient substance abuse treatment

Health Plan Options
There are two plan options available. The family income will determine in which plan you are enrolled. Health Check is the Medicaid program for the lowest income families and Health Choice is available to families that are not eligible for Medicaid but meet the NCHC income guidelines.

Premium Payments, Co-Payments and Coinsurance
There may be some out-of-pocket costs associated with services received under the NCHC program. The total share paid by any family may not exceed 5% of the total family income. For children in higher income families, there is a $50 enrollment fee for one child and $100 for two or more children. If your monthly income is above the 150% of poverty level, there are co-pays for prescription drugs, doctor's visits and emergency room use. If your monthly income is 150% of poverty and below, you only have co-pays ranging from $1 to $3 for prescription drugs. There are no premiums payments required to participate in this health care program.

Program Length, Enrollment and Renewal
For information on coverage lengths and renewal requirements, contact NCHC directly.

NCHC Contact Information
North Carolina. Health Choice
PO Box 30111
Durham, NC 27702-3111
1-800- 422- 4658

North Carolina Health Choice Website

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