Adult Medicaid
FREQUENTLY ASKED QUESTIONS
Where do I apply for adult Medicaid?
Applications are taken daily at 741 North Highland Avenue in downtown
Winston-Salem. No appointment is needed. You may also print out instructions and an application. Please note that the application must be mailed to the
address below or brought to the office in person.
Department of Social Services
741 N. Highland Avenue
Winston-Salem, NC 27102
Attn: Adult Medicaid
What are the income requirements for Adult Medicaid?
Income limits for individuals are $851 a month and $1141 for couples for the disabled (under age 64) and the aged (over
age 65). The reserve limit is $2,000 for an individual and $3,000 for couples. The reserve limit for other Medicaid
programs is $4,000 for an individual and $6,000 for couples. Reserve limits include bank accounts, stocks, bonds, cash
value of life insurance, etc. You may come into the office to apply if you are unsure of income or reserve limits.
Can I call if I am not sure I want to apply?
You can reach us at (336) 703-3502. We will be glad to answer
your questions. Because of the complexity of the Medicaid programs, we cannot give you an answer over the phone about the
likelihood of being eligible. The only way to know about eligibility, is to sign an application and let us complete the
process.
What are the "tests" one needs to pass to receive Medicaid?
There is a initial three part test to determine
eligibility: Basic "medical" need; Age or Disability; and Financial. Each one of these parts must be passed before you can
get Medicaid to pay for care. If any one is missing you will not be eligible for the program and will have to pay for
care privately; that is, out of your own pocket.
What do we mean by medical need?
The standards to determine whether or not the need is present are:
- The need must require twenty-four hour nursing care in a "skilled care facility." A skilled care facility is one where professional nursing services are available and include, physicians, respiratory care, audiologists, physical and occupational therapists.
- The individual's needs are so medically complex that they require supervision, assessment or planning by a Registered Nurse.
- The individual must need the care on a daily basis.
- The individual needs ongoing involvement of a Registered Nurse or other professional in the evaluation of the individual and the implementation of a treatment plan.
- The individual needs continuous observation in order to monitor for complications or change in the status of his condition.
- Lastly, the care the individual needs should not be of a degree which would normally be provided by a hospital.
What do you need to apply for adult Medicaid to support medical need and to show financial need?
The process
of making an application for Medicaid can be complex and require a considerable amount of information. Here is a list of
information that may be needed in making an application.
- Recent medical bills
- Statements and payments made to medical providers
- Canceled checks to medical providers
- Health insurance receipts
- Proof of medical transportation costs
- Proof of income for the last several months
- Statement from employer
- Copy of checks
- Record of payments received
- Self-employed records
- Bank statements and account numbers
- Checking account statements for the last several months
- Bankbooks. Current savings statements
- Security account statements
- Copies of stock certificates
- Life Insurance policies and policy numbers
- Social Security card or number for client and family members
- Health insurance information
- Policy cost, statements, payments and coverag
- Proof of legal alien status (if applicable).
Whenever you have questions about what is needed, please call your Caseworker. We are here to answer your questions!
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