Get Ncdss Forms

a. A valid North Carolina drivers' license or other identification card issued by the North Carolina Division of Motor Vehicles. b. A current North Carolina rent, lease, or mortgage payment receipt, or current utility bill in the name of the applicant or the applicant's legal spouse, showing a North Carolina address.

Call 1-800-662-7030.

A North Carolina Medicaid prior authorization form is a document used by North Carolina-based medical professionals to request Medicaid coverage for a non-preferred drug. On the form, the person making the request must provide the medical justification for not prescribing a drug from the Preferred Drug List.

NC Medicaid Managed Care Health Plans. Behavioral Health I/DD Tailored Plans. EBCI Tribal Option. Health Plan Contracts.

The NCFAST-20020 is a prepopulated renewal form for the beneficiary to validate that current information remains the same or indicate changes and provide self-attestation of eligibility requirements, including income.

Qualifying When Over the Limits The Medically Needy Income Limit (MNIL) has remained the same for many years, and in 2023, continues to be $242 / month for a single individual and $317 / month for a married couple.