20 CAR § 575-104 – Medicaid eligibility unaffected

(a)
1. (1) Enrollment in a health plan does not change the client's eligibility for Medicaid benefits.
2. (2) If services covered under Medicaid are not covered by the health plan, payment for those services is made according to the applicable Medicaid payment methodology.
3. (3) If the client's health plan offers more services than covered under Medicaid, the Division of Medical Services does not pay for the deductibles, coinsurance, and other cost-sharing obligations for those noncovered services.
(b) Medicare enrollment. If the client is also eligible for Medicare Part B but is not enrolled in Medicare Part B, the division does not pay for the premiums or cost-sharing obligations to the health plan unless cost effective.
(c) Medicaid cost-sharing amounts. If the client is required to pay Medicaid cost-sharing amounts, payment of the cost-sharing amounts is not covered by the HIPP program.