Family Planning Waiver/Coverage Gap Persons Information


Courtesy of Senator Angela Bryant:

Below is an excerpt from the DMA website about the Family Planning Waiver that North Carolina currently has approved by CMS:

Be Smart. Be Ready.

Free Reproductive Health Services in North Carolina

Facts about the Medicaid Family Planning “BE SMART” Program

What is the Medicaid Family Planning “BE SMART” program?

The Medicaid Family Planning Program, or “BE SMART” program, is designed to reduce unintended pregnancies and improve the well-being of children and families in North Carolina. Family planning/reproductive health services are provided to eligible men and women whose income is at or below 195% of the federal poverty level.

 

Who can enroll with Medicaid to provide Family Planning Services under the “BE SMART” program?

  • Ambulatory surgery centers

 

 

  • Nurse practitioners

 

 

  • Birthing centers

 

 

  • Nurse midwives

 

 

  • Certified Registered Nurse Anesthetists

 

 

  • Outpatient hospitals

 

 

  • Federally Qualified Health Centers

 

 

  • Physicians

 

 

  • Laboratories

 

 

  • Rural health clinics

 

 

  • Local health departments

 

What services are covered under the “BE SMART” program?

The following services are covered through the “Be Smart” when provided as part of a family planning visit:

  • Annual and periodic office visits (including counseling, patient education, and treatment)
  • Specific laboratory procedures (i.e., pap tests, pregnancy tests)
  • FDA-approved and Medicaid-covered birth control methods, procedures, pharmaceutical  

      supplies, and devices

  • Screening for HIV (Human Immunodeficiency Virus)
  • Screening and treatment for specific Sexually Transmitted Infections (STIs)
  • Voluntary sterilization (in accordance with federal sterilization guidelines)

Note: There is no co-payment for beneficiaries for services received through the “BE SMART” program. When services are not covered under the “BE SMART” program and the provider does not offer affordable or free care, patients should be referred to their local department of social services (DSS) for a list of primary care “safety net” providers.

Who can sign up for the “BE SMART” program?

Eligible individuals whose income is at or below 195% of the federal poverty level and who are:

  • S. citizens, documented immigrants or qualified aliens;
  • Residents of North Carolina;
  • Not incarcerated;
  • Not pregnant; and
  • Not permanently sterilized.

How can I sign my patients up for the “BE SMART” program?

Individuals interested in applying may get an application from their local DSS, health department or on-line at http://www.ncdhhs.gov/dma/medicaid/applications.htm. The completed application must be returned to their local DSS.

Who do I contact if I have questions about the “BE SMART” program?

For more information about this special Medicaid program, please visit North Carolina’s Medicaid website at http://www.ncdhhs.gov/dma/medicaid/familyplanning.htm.

A full explanation is at the following link  http://www.ncdhhs.gov/dma/medicaid/familyplanning.htm