NC pilot program, online tools valuable for Medicaid beneficiaries

Dr. Max Cuevas, a community engagement representative for the health care intermediary WellCare of North Carolina, said that there are over 100,000 Medicaid beneficiaries in Region 6 of the state's Medicaid Managed Care regions. That area includes Pitt, Greene, Edgecombe, Martin and 23 other counties in the eastern part of the state.

Cuevas said a Feb. 3 block party hosted by WellCare at the Greenville Mall was among many events planned to share information on providers and coverage to people who could benefit.

The events are in response to the state expanding Medicaid coverage to more people in December. At that time, the state reported that 600,000 more North Carolinians would become eligible for coverage.

Carrie Woodruff, a registered nurse, said that Medicaid expansion is key to providing better health care in rural areas like Pitt County and making service accessible to people who might have geographical or physical obstacles standing in the way of treatment.

Montiara Brown of Greenville was at the event with her son, Messiah Brown, seeking more information on Medicaid. She has been a recipient for four years, since her son was born, and said that it helps provide a feeling of security while also helping with social services like child care.

"He was a pandemic baby so they extended (Medicaid) for the mothers," said Brown. "That's how I still have it.

"I use it for dental, to get glasses. Without Medicaid I wouldn't be able to get glasses, that's outside of my budget since I'm a single parent."

Brown also is a part of the Healthy Opportunities Pilot, or HOP, program offered through the state which provides select, non-medical interventions to Medicaid beneficiaries. That can include food, transportation and utilities. The program was authorized by the Centers for Medicare and Medicaid Services and launched on March 15, 2022. It will continue through Oct. 31 of this year at the cost of up to $650 million in state and federal Medicaid funding.

Brown said the program has helped her pay light bills and find a new place to live.

"They helped me with moving into a two-bedroom," Brown said. "They paid my security deposit, first month's rent, also paid for my utilities to be changed over from where I was staying to my new residence. They also gave me $1,050 for household items.

"It helped with the whole transition and it gave me a step up. To pay for all of that, it would have took me forever to save up for that. Like, years and years. I probably would've given up by then. I felt like I was stuck where I was at but they helped me."

The HOP program has launched in 33 of the state's 100 counties, 15 of which are in eastern North Carolina. The other 18 are in the state's westernmost counties. The state's website said that Medicaid beneficiaries who want to participate in the HOP program must have at least one qualifying physical or behavioral health condition and one qualifying social risk factor. A full list of those factors can be found online.

Taneil Cherry of Greenville said she has had trouble finding a provider for eye and vision services in the city and that she has had to travel to Raleigh or Snow Hill to receive care. However, an online search tool from the N.C. Department of Health and Human Services shows that there are nine local providers of vision care who are currently accepting new patients.

The tool allows Medicaid recipients to search for providers who accept their insurance by city, county or zip code. It also narrows down selections to medical specialties. Visit this story on reflector.com for links to the tool and HOP program qualitications.