This bulletin applies to NC Medicaid Direct.
This bulletin is to inform providers that all individuals with Medicaid for Qualified Medicare Beneficiary/Medicaid Specified Low Income Medicare Beneficiary (MQB-Q/B) now also have coverage under the Family Planning Program. This means that beneficiaries with MQB-Q or MQB-B will continue to have coverage for Medicare premiums, copays and deductibles and will now also have coverage for Family Planning services.
Coverage Family Planning services include:
- Contraception
- Health screenings
- Testing and treatment for STDs
- Related lab services
- HPV vaccines and sterilization procedures
For more details on the services covered, see Clinical Coverage Policy 1E-7 Family Planning Services.
Providers should inform patients with this coverage about this change, so they are aware.
Please note that Medicaid Qualifying Individuals 1(QI1) (MQB-E) beneficiaries who receive only help paying Medicare premiums are not eligible for Family Planning coverage.
Providers and pharmacies should always use NCTracks to verify NC Medicaid eligibility and category of coverage. For guidance, please reference the Refresher: How to Confirm Medicaid Coverage for Beneficiaries bulletin for more information.
Contact
NCTracks Call Center: 800-688-6696