An important change is here for pregnant and postpartum Medicaid beneficiaries. A provision of the American Rescue Plan gave states the option to extend Medicaid postpartum coverage from 60 days to 12 months. Extended coverage became effective in North Carolina on April 1, 2022. Individuals enrolled in Medicaid for Pregnant Women will now see their coverage extended for a 12-month period after their pregnancy ends.
Research has found that 1 in 3 pregnancy-related deaths occur 1 week to 1 year after delivery. Furthermore, Black and American Indian/Alaska Native women are about 3 times as likely to die from a pregnancy-related cause as White women. By extending coverage, this needed change stands to improve maternal health and stabilize healthcare coverage for postpartum individuals.
Who is eligible?
As of April 1, 2022, Medicaid for Pregnant Women beneficiaries in North Carolina saw their coverage extended for a 12-month period after the pregnancy ends, regardless of any changes in circumstances or if the pregnancy ends for any reason.
A renewal must be completed at the end of the 12-month postpartum period to determine if beneficiary will be eligible for Medicaid after the postpartum period. If/when Medicaid terminates, individuals may be eligible to enroll in affordable coverage with the Health Insurance Marketplace through a Special Enrollment Period.
Please note, Medicaid eligibility rules have not changed in the state of North Carolina.
What is the postpartum period?
The postpartum period is a full 12-months following the end of pregnancy for any reason. This includes pregnancies that may end in miscarriage or stillbirth. The period begins on the date the pregnancy ends and extends through the end of the month in which the 12-month period ends. For example, if a Medicaid beneficiary gives birth on May 5, 2022, their Medicaid coverage will be extended through May 31, 2023.
How do I enroll?
Individuals may apply for NC Medicaid online at epass.nc.gov, in person or by phone at their local Department of Social Services (DSS) office, or by filling out a paper application and mailing, faxing, or dropping it off at their local DSS office.
Health Insurance Navigators are available to help individuals to learn if they are eligible for Medicaid programs in North Carolina, and to complete a Medicaid application. Visit NCNavigator.net, call 855-733-3711, or 980-256-3782 in Mecklenburg, Cabarrus, or Union counties to schedule a free appointment.
If Medicaid is approved, individuals need to report when the baby is born to their local DSS office. This must be done no matter which Medicaid program/category the beneficiary receives. The case worker will then extend the Medicaid coverage through the postpartum period. A letter will be sent to the beneficiary letting them know of the change and the certification periods.
When does the change start?
The effective date of this policy is April 1, 2022. The extended coverage is currently authorized through March 2027.
What if I have questions or need help?
Health insurance navigators are ready to help! Visit NCNavigator.net, call 855-733-3711, or 980-256-3782 in Mecklenburg, Cabarrus, or Union counties to schedule a free appointment.