The North Carolina Department of Health and Human Services (NCDHHS) on Thursday launched the NC Medicaid Optional COVID-19 Testing program, which will reimburse Medicaid providers for costs associated with COVID-19 testing of people without insurance.

“North Carolina is making COVID-19 testing more available and affordable, and this program will help,” said Gov. Roy Cooper, “but the most important way to keep people healthy is to expand Medicaid so 600,000 North Carolinians can get health insurance, which the legislature should do immediately.”

“This new program allows community providers to offer cost-free testing to uninsured North Carolinians. It’s a good step to decrease barriers to testing. However, to help North Carolinians who don’t have health insurance get the full range of care needed for COVID and to access needed preventive care, North Carolina needs to expand Medicaid like most other states have done,” said NCDHHS Secretary Mandy Cohen, MD.

Federal funding will be available to cover 100% of costs directly related to COVID-19 testing, including both viral and serological or antibody tests, through the federal Families First Coronavirus Response Act. In North Carolina, Medicaid-enrolled providers may file directly with NC Medicaid for reimbursement for testing eligible uninsured individuals. Costs for COVID-19 tests will be covered retroactively up to three months if people were uninsured at the time of the test. 

To qualify for the program’s testing coverage, people must meet three checks: Live in North Carolina, not be eligible for or enrolled in Medicaid or have other health insurance; hold U.S. citizenship or other legal immigration status as mandated by federal regulations.

The reimbursement program will continue during the duration of the COVID-19 federal declaration of emergency. The NCDHHS website offers resources for individuals and health care providers interested in learning more about or participating in the program.

Since the beginning of the pandemic, North Carolina has worked to remove access and cost barriers to testing while increasing capacity statewide. In addition to coordinating overall testing capacity and supporting providers, NCDHHS has also directly funded community testing sites and events in targeted communities at higher risk of exposure. 

NCDHHS recommends testing for anyone experiencing COVID-19 symptoms, as well as for any asymptomatic individual who believe they may have been exposed, especially people from historically marginalized communities. Information about upcoming community testing events can be found on the Community Testing Events page of the NCDHHS COVID-19 website, and testing sites can be located via Find My Testing Place.

Background on Medicaid Expansion

Expanding Medicaid would help 600,000 North Carolinians access affordable health insurance, including veterans, families with children and others. Medicaid expansion would provide coverage for many individuals who have lost their jobs due to the COVID-19 pandemic.

North Carolina is one of 12 states that has not expanded Medicaid. Governor Cooper has pushed the legislature to close this coverage gap through a proposal that wouldn’t cost the state any extra money. Even Indiana expanded Medicaid when Vice President Mike Pence was governor. 

Expansion would benefit everyone, as it lowers health care costs for consumers as well as employers who buy health insurance. In fighting the opioid epidemic that continues to ravage our communities, Medicaid expansion would play a critical role, providing coverage for substance abuse services.

Medicaid expansion doesn’t just benefit individuals; it helps rural hospitals keep their doors open by paying for services that hospitals must provide regardless of insurance status. Hospitals face serious financial pressures in the wake of COVID-19, but these problems are not new. Uncompensated care threatens the sustainability of these critical lifelines. Medicaid expansion would bolster rural hospitals and help address inequities in care around our state.

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