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Details for Service Health Check
Service Name Health Check Program Name At-Risk Family Health and Safety Benefits
Goal 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.
Objective Assure that families at risk of economic challenges receive health and safety benefits to mitigate those risks.
Division Division of Health Benefits
Service Description

The Health Check program includes regular preventive medical care and the diagnosis and treatment of any health problem found during a screening. There is no separate enrollment in Health Check. If someone is eligible for Medicaid and is under the age of 21, they automatically receive Health Check services. These services are also called Early Periodic Screening, Diagnosis and Treatment (EPSDT) services.

 

These services are important because they identify treatments that are medically necessary to correct or ameliorate a defect, physical or mental illness or a condition that is identified through a screening examination.

Health Check services are mandatory.

Services must be ordered by the Medicaid child's physician or another licensed clinician. Prior approval from the Division of Medical Assistance may be required to verify medical necessity for some services.

Web Site http://www.ncdhhs.gov/dma/ Year First Initiated 1993
Available State Wide Yes Geographic Area Served
Grants Provided No Competitive Bidding No
Competitive Bidding Details
Waiting List No Waiting List Start Date
Number Waiting
Waiting List Details

Income Eligibility
Income Eligibility Yes
Income Eligibility Method 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
Income Eligibility Type Earned income such as: wages, self-employment Unearned income such as: RSDI, unemployment, VA, retirement, child/spousal support, worker's compensation, etc.
Whose Income Eligibility Individual on the Medicaid case + financially responsible individuals in the home - (Parent for child under age 21 or spouse).
Income Disregard Yes
Income Disregard Desc 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
Income Verified Yes
Income Verified Method Electronic match with ESC, SSA, wage stubs, verification from source of income, such as VA, employer, award letter, self-employment records
Income Criteria Federal and State Statutes are used as a base for setting income levels.
Income Eligibility Change 1/1/2006
Income Eligibility Method Prior To Change 185% MIC children less than 1 133% MIC children 1-5
Income Eligibility Other

Target Population
Age Range Start Age Range End
0 20

Legal Authority
Authorization Level Authorization Type Citation
Federal Public Law 42 U.S.C.ยง 1396d(r) [1905(r) of the Social Security
Federal Code of Federal Regulations 42 CFR 440.40

Budget Information
State Fiscal Year (SFY)
As of the month of
Authorized Budget Fiscal Year 2024 SFY 2023-2024 Year To Date Expenditures Balance
Salary and Fringes (1X) 0 0 0
Salary Other (1X) 0 0 0
Operating (2X-5X) 0 0 0
Contracts/Allocations (6X) 0 0 0
Reserves (7X) 0 0 0
Transfers (8X) 0 0 0
Total Requirements 0 0 0
Receipts-Federal 0 0 0
Receipts- Local receipts 0 0 0
Receipts- Other receipts 0 0 0
Total Receipts 0 0 0
General Fund Appropriations 0 0 0
Match
State Local Other
0 0 0
 
MOE
State Local
0 0
 
FTEs
0.00
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