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NC Department of Health and Human Services
NC Division of
Medical Assistance

Este programa En EspanolWhat is Health Choice for Children

Health Choice logoThe North Carolina Health Choice (NCHC) Health Insurance Program for Children is a comprehensive health coverage program for low-income children. The goal of the NCHC Program is to reduce the number of uninsured children in the State. If your family makes too much money to qualify for Medicaid, but too little to afford private or employer-sponsored health insurance, your child (ren) may qualify for NCHC.

Health Choice Claims Transition Information

What Does NCHC Cover? 

NCHC benefits include the following:

  • Case management and care coordination services
  • Dental services
  • Durable medical equipment and disposable medical supplies
  • Emergency Services
  • Family planning services
  • Hospice care
  • Home health care
  • Immunizations (shots)
  • Inpatient and outpatient substance abuse treatment
  • Laboratory and radiological services
  • Mental health services (inpatient and outpatient)
  • Physician and clinic services (well-child and sick visits)
  • Physical therapy, occupational therapy and therapy for individuals with speech, hearing and language disorders
  • Prescription drugs
  • Substance Abuse Services (inpatient and outpatient)
  • Surgical services

Some of the items NCHC does not cover include:

  • Inpatient/Long-term care services; including LTC under Private Duty Nursing and Personal Care Services.
  • Services for beneficiaries who are outside the USA, or services to prepare a beneficiary to travel outside of the USA.

Please see all service eligibility requirements, coverage criteria, and limitations indicated in the Medicaid and Health Choice Clinical Coverage Policies.

DMA Claims Analysis

To verify eligibility for dates of service over 12 months old, contact DMA Claims Analysis at 919-855-4045.

Consumer Notices and Handbooks

See the DMA Consumer Library for a copy of the handbooks and Health Choice beneficiary notices. Ready NC Connect NC