SPECIAL BULLETIN COVID #128: NC Medicaid Optional COVID-19 Testing Program Online Applications Available

NOTE: This article was updated on:

1. Sept. 14, 2020 to clarify that the online application is only available in English. Paper applications are available in English and Spanish.
2. Nov. 18, 2020 to update that MVC now qualify for coverage of COVID-19 tests restriactive to three months prior.

NC Medicaid is reimbursing COVID-19 testing costs for individuals without insurance who enroll in the NC Medicaid Optional COVID-19 Testing (MCV) program. This option was made available to all states through Section 6004(a)(3) of the Families First Coronavirus Response Act (FFCRA). Enrolled MCV beneficiaries will also qualify for coverage of COVID-19 tests retroactive to three months prior provided they were uninsured at the time of the test.

A fact sheet that highlights the MCV program is available at https://medicaid.ncdhhs.gov/about-us/covid-19-guidance-and-resources/providers.

Applications

Individuals may apply online for the MCV program in English at https://epass.nc.gov/nf-apply-for-covid-testing/overview. The online application also is available on a mobile device. Signage is available for posting in testing areas at https://medicaid.ncdhhs.gov/about-us/covid-19-guidance-and-resources/providers. 

Paper applications, in English and Spanish, are available for individuals who need them. Please mail paper applications to the address on the form. However, NC Medicaid encourages applying online as paper applications are estimated to take 2 weeks to process. 

MCV Program 

To qualify, individuals must be uninsured, a resident of North Carolina, and meet the citizenship and legal immigration status requirements of the Medicaid program. NC Medicaid is required to verify citizenship and immigration status. Individuals must qualify for MCV at the time the test was obtained.

NOTE: Individuals currently enrolled in NC Medicaid’s limited “Family Planning Only” benefit and who have no other health insurance coverage will automatically be enrolled in the MCV program and will not need to complete an application. 

An individual must qualify for the MCV program prior to payment for testing services. Testing site providers must be enrolled in Medicaid to receive payment.

Verifying Eligibility

As there will be a delay between when the application is received and when it is processed, providers will need to wait until the individual is enrolled in MCV to submit claims for testing. Once an individual is enrolled, they will remain in the program throughout the federal public health emergency. 

To determine whether an individual is enrolled in the MCV program, testing site providers can: 

• Check the NCTracks Portal to confirm Medicaid MCV enrollment and then bill NCTracks for testing provided; 
• Allow beneficiaries to apply online or collect paper applications at testing location; then submit applications to Medicaid and wait approximately 2 weeks for application processing. Finally, check the NCTracks Portal to confirm Medicaid MCV enrollment; and then bill NCTracks for the testing provided; or
• Bill HRSA for individuals who are not enrolled in Medicaid.

Contact

NC Medicaid Contact Center: 888-245-0179