Frequently Asked Questions for Beneficiaries

Who can contact the local Department of Social Services to report a new pregnancy or one that has ended? 

To get postpartum care for 12 months, you must call or visit your local DSS caseworker: 

• when you become pregnant  
• if your due date changes 
• when your pregnancy ends 

Reports can be made by phone, mail, fax or in person by providers, hospitals or family. Your DSS caseworker will set the dates for your 12-month postpartum care period and make changes as needed.

How long will an eligible beneficiary get full Medicaid benefits?

If you are in the Medicaid for Pregnant Women program, your full Medicaid benefits start when the pregnancy ends. The 12-month postpartum care period will end on the last day of the 12th month. 

What services are covered for beneficiaries who are eligible for full Medicaid benefits? 

Most pregnant and postpartum beneficiaries will get full Medicaid benefits. This may include services like doctor’s visits, prescription drugs, dental, vision and hearing coverage. It also may include behavioral health care and substance use services. you can find a full list of benefits here. 

Should I let my local Department of Social Services know if I have  a change in income, job information, household size or other life changes during my 12-month period? 

Beneficiaries must report all life changes to their local DSS within 10 days.

What happens to Medicaid coverage when a pregnancy ends (for any reason)?

When a pregnancy ends, it is important to let your local DSS know. Your DSS caseworker can make sure your eligibility will end on the right day. The 12-month postpartum care period will end on the last day of the 12th month unless you are eligible for other Medicaid coverage.

How will I know if I can get postpartum coverage?

Beneficiaries are eligible for postpartum care if they are: 

• A beneficiary of a Medicaid program that covers the birth of a child 

In a 60-day postpartum period Beneficiaries can get full Medicaid benefits even if they have a life change, such as: 

• A change in income  
• A change in your household (for example, you get married or divorced)

For the postpartum care benefit, life changes that would not qualify for continued Medicaid coverage include if someone in your household dies, you move to a new state or if you ask to leave the Medicaid program.

How can I enroll in NC Medicaid to get the postpartum benefit?

Beneficiaries currently in the Medicaid for Pregnant Women program will automatically get 12-months of postpartum care and full Medicaid benefits. 

If I have questions, who can I call for help?

If you have questions, contact your local DSS. For more help, you can call the NC Medicaid Contact Center at 1-888-245-0179, Monday – Friday, 8 a.m. to 5 p.m. 

Remember to update your contact information. 

If you or someone in your family has recently changed their address or phone number, make sure to tell your local DSS caseworker. Your address is used to send important documents and information.