Medicare
Benefit: Medicare is health insurance that helps pay for preventive care, doctor visits, hospital stays, and prescription drugs.
Who can apply: You must be 65 years of age or older or under age 65 and meet the disability guidelines
Medicare Plans in North Carolina: https://www.payingforseniorcare.com/medicare/north-carolina
How to apply:
Dial 1-800-772-1213 to reach the Social Security Administration toll-free, and let the operator know your address. To learn more about Medicare’s prescription medication coverage, call 1-800-MEDICARE at 1-800-633-4227 or visit www.medicare.gov. You can also log on to www.socialsecurity.gov and choose “Questions about Medicare.” Call the State Health Insurance Assistance Program (SHIP) at 1-800-434-4036 or 864-242-9733 at 8:30 a.m. for further information. to 5:00 p.m. The weekdays are Monday through Friday.
Medicare Savings Programs
Benefit: This benefit helps pay for some of your Medicare costs, which can include the Part A and B premiums, deductibles, and co-payments. The amount of help you get depends on your income and resources.
Who can apply:
For North Carolina residents, you must have Medicare and have a limited income of around $1,357 per month (single) or $1,823 per month (married).
For South Carolina residents, you must have Medicare and have a limited income of around $1,226 per month (single) or $1,655 per month (married).
How to apply:
Online applications are available at www.scdhhs.gov. They are also accessible from outlying places, including the local Health Departments, federally designated rural health facilities, most hospitals, and the local Department of Social Services, as well as the Department of Health and Human Services. Applications may be submitted in person or by mail. Call 1-888-549-0820 toll-free for additional details.
Medicare Rx Extra Help
Benefit: This benefit lowers the cost of your prescription drugs offered through Medicare Prescription Drug Coverage (Part D). The monthly premium, deductible, and co-payments you pay depend on your income and resources.
Who can apply:
For North Carolina residents: You must have Medicare and have limited income and resources. Your income must be less than $17,820 a year, and your resources must be less than $13,640 if you are single. If you are married and living together, your income must be less than $24,030 a year and your resources must be less than $27,250.
For South Carolina residents: Medicare recipients have a total net worth of no more than $12,510 for singles and $25,010 for couples who are married and living together and who have a limited income ($1362 for individuals and $1839 for couples).
How to apply:
Ask for the Medicare Rx Extra Help application by calling the Social Security Administration toll-free at 1-800-772-1213. In addition, you can log in, go to www.socialsecurity.gov, and select the Medicare part. Call the State Health Insurance Assistance Program (SHIP) at 1.800.434.4036 or 864.242.9733 at 8:30 a.m. for further information. to 5:00 p.m. The weekdays are Monday through Friday.
North Carolina Drug Card
Benefit: The North Carolina Drug Card is a free statewide prescription assistance program. You can get savings of up to 75% off the cost of your prescription medication. The card must be used at participating pharmacies.
Who can apply: You can get this card if you live in North Carolina.
Medicaid
Benefit: Medicaid helps make medical coverage more affordable and pays for services such as:
hospital care (inpatient and outpatient), health center and clinical services, visits to your healthcare providers (including your physician and nurse practitioner), lab tests and x-ray services, nursing home care, and prescription drug coverage (in certain cases). In addition, if you have Medicare, Medicaid may help pay for some of your Medicare costs.
How to know if you’re eligible for Medicaid in North Carolina
In North Carolina, you must meet certain medical, financial, and asset requirements to obtain Medicaid and help pay for long-term care. To qualify for Medicaid, you must:
- Be a full-time North Carolina resident.
- Be a U.S. citizen or have legal immigration status.
- Be age 65 and up, blind, or disabled with a qualifying disability consistent with the level of care being requested.
- Have a monthly combined income that is no more than 100% of the federal poverty rate—although Medicaid will cover care costs for medically needy applicants whose income exceeds these rates.
- Have assets totaling $2,000 or less if single, with $3,000 allowed for married couples with both individuals requiring care
How to know if you’re eligible for Medicaid in South Carolina
All state-wide Medicaid eligibility determinations are handled by the South Carolina Department of Health and Human Services. People who are approved for Medicaid through the Social Security Administration are frequently approved for SSI as well, and they are able to enroll in both programs at the same time. To qualify, applicants must:
- Be at least 65 years of age, blind or disabled
- Be a U.S. citizen or legal resident and a permanent resident of South Carolina
- Meet income guidelines
How to apply:
Get an application from the Department of Health and Human Services or from regional places, including the County Health Departments, federally recognized rural health clinics, most hospitals, and the county Department of Social Services.
Applications for Medicaid may be filed in person or by mail. For more information, call toll-free at 1-888-549-0820 or log on to www.scaccesshelp.org to apply online.
Other long-term care benefits in North Carolina
- State-County Special Assistance
Individuals who receive Social Security Disability Insurance or Supplemental Security Income are automatically entitled to Medicaid. Additionally, North Carolina offers State-County Special Assistance to help individuals who are elderly, blind, or disabled and need help paying for the cost of room and board provided by an assisted living facility or adult care home.
- Program of All-Inclusive Care for the Elderly
PACE is another option for seniors aged 55 or older who require nursing-level care. There are multiple payment options for individuals who qualify for Medicaid, Medicare, or private private pay. With PACE, all medical and long-term care services are provided by a single organization, but the program pays for any services that you need. However, there are geographic restrictions. You must reside in a participating ZIP code. The state has 11 regional PACE programs. You can see if these services are available in your area by visiting the National PACE Association
Other senior benefits in South Carolina
Seniors’ Farmers’ Market Nutrition Program (SFMNP) Is intended to give low-income seniors access to locally grown fruits, vegetables, honey, and herbs, increasing domestic consumption of agricultural products through farmers’ markets, roadside stands, and community supported agriculture programs. It also aims to support the development of new and additional farmers’ markets, roadside stands, and these programs. In South Carolina, the Department of Social Services (for elders) and the Department of Agriculture (for farmers) collaborate to administer the SFMNP.