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Details for Service Dental
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Service Name
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Dental
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Program Name
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At-Risk Family Health and Safety Benefits
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Goal
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Provide outreach, support and services to individuals and families identified as being at risk of compromised health and safety to eliminate or reduce those risks.
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Objective
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Assure that families at risk of economic challenges receive health and safety benefits to mitigate those risks.
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Division
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Division of Health Benefits
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Service Description
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NC Medicaid covers most diagnostic and preventive dental services such as exams, radiographs, dental cleanings, fluoride treatments and sealants for adults and children. These covered services are important in the detection and prevention of oral health problems. Fillings, root canals, periodontal services, oral surgery procedures and partial and full dentures are also covered.
These dental treatment services result in the restoration and/or maintenance of function and oral health. Orthodontic services are covered for children under age 21 with functionally impairing malocclusions. Poor oral health is often linked to many chronic and acute diseases in research studies. The services covered by the DMA Dental Program are designed to promote not only a healthy mouth and dentition, but also better overall systemic health.
| Dental services are optional. Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21. |
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Web Site
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http://www.ncdhhs.gov/dma/
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Year First Initiated
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1975
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Available State Wide
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Yes
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Geographic Area Served
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Grants Provided
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No
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Competitive Bidding
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No
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Competitive Bidding Details
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Waiting List
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No
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Waiting List Start Date
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Number Waiting
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Waiting List Details
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Income Eligibility
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Yes
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Income Eligibility Method
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Eligibility for Medicaid is determined by the county departments of social services (DSS) and the Social Security Administration (SSA) for Supplemental Security Income (SSI) recipients.
200% FPL - MIC children under age 6
185% FPL - MPW
133% FPL - MIC children age 1-5
100% FPL - MIC children 6-18, MAD, MAA, MAB
150% FPL -HCWD
MAF-CN, HSF Categorically Needy:
1 person - $362
2 - $472
3 - $544
4 - $594
5 - $648
MAF, MAD, MAA, MAB Medically Needy:
1 person - $242
2 - $317
3 - $367
4 - $400
5 - $433
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Income Eligibility Type
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Earned income such as: wages, self-employment
Unearned income such as: RSDI, unemployment, VA, retirement, child/spousal support, worker's compensation, etc.
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Whose Income Eligibility
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Medicaid case + financially responsible individuals in the home - (Parent for child under age 21 or spouse).
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Income Disregard
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Yes
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Income Disregard Desc
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Earned Income Disregards:
MAA, MAD, MAB: $65 + 1/2 remainder
MAF-C - 27-1/2%
MAF-N/M, MIC, MPW, HSF: $90 + child/adult care up to $175/200
Unearned income disregards:
MAA, MAD, MAB: $20 general exclusion, 1/3 child support
MAF, MIC, MPW, HSF: $50 of child/spousal support
Work expense exclusion for the blind: MAB, HCWD
Impairment related work expense for the disabled - MAD, MAB, HCWD
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Income Verified
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Yes
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Income Verified Method
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Electronic match with ESC, SSA, wage stubs, verification from source of income, such as VA, employer, award letter, self-employment records
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Income Criteria
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Federal and State Statutes are used as a base for setting income levels.
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Income Eligibility Change
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1/1/2006
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Income Eligibility Method Prior To Change
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185% MIC children less than 1
133% MIC children 1-5
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Income Eligibility Other
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Age Range Start
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Age Range End
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0
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100+
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Authorization Level
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Authorization Type
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Citation
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State
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Administrative Rules
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10A NCAC 22O.0115; 0200
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Federal
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Code of Federal Regulations
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42 CFR 440.100
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Federal
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Public Law
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Social Security Act Section 1902 (a) (43) [codified as 42 USC 1396a (a) (43)] and Section 1905r [codified as 42 USC 1396d(r)]
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Budget Information
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State Fiscal Year (SFY)
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As of the month of
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Authorized Budget Fiscal Year 2024
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SFY 2023-2024 Year To Date Expenditures
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Balance
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Salary and Fringes (1X)
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0
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0
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0
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Salary Other (1X)
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0
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0
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0
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Operating (2X-5X)
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0
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0
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0
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Contracts/Allocations (6X)
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0
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0
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0
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Reserves (7X)
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0
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0
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0
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Transfers (8X)
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0
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0
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0
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Total Requirements
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0
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0
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0
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Receipts-Federal
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0
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0
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0
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Receipts- Local receipts
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0
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0
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0
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Receipts- Other receipts
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0
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0
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0
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Total Receipts
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0
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0
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0
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General Fund Appropriations
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0
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0
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0
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Match
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State
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Local
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Other
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0
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0
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0
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