SPECIAL BULLETIN COVID-19 #242: Continued Reimbursement for COVID-19-Related Services for the Uninsured
Optional Eligibility Group and HRSA Group are different

Optional Eligibility Group and HRSA Group are different

NC Medicaid continues to reimburse providers for COVID-19 related services for the NC Medicaid Optional Eligibility Group (which includes the uninsured (MCV) and MAFDN Family Planning Group). This program was initiated in 2020 for COVID-19 and expanded by the America Rescue Plan Act to include COVID-19 treatment and vaccination. NC Medicaid will continue to operate this program through the federal public health emergency.

It was recently announced that the Health Resources and Services Administration (HRSA) -led initiative to reimburse for COVID-19 testing and treatment will end. This program also reimbursed health care providers for delivering COVID-19 testing, treatment and vaccines to those without health insurance. As of March 22, 2022, the program stopped accepting claims for testing and treatment services. On April 5, 2022, the program will stop accepting claims for vaccine administration. 

This bulletin services as a reminder that the two programs are separate entities and that NC Medicaid will continue to reimburse providers who deliver COVID-19 treatment, testing and vaccine administration for the uninsured in the state. To be eligible for the program, individuals must:

  1. Enroll in Medicaid for the uninsured (MCV) group or MAFDN Family Planning.
  2. Be uninsured.
  3. Be a resident of North Carolina.
  4. Meet the citizenship and legal immigration status requirements of the Medicaid program.

Detailed eligibility requirements may be found in SPECIAL BULLETIN COVID-19 #206.


NC Medicaid Contact Center: 888-245-0179

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