Certain individuals with mental illness may be able to qualify for Medicaid coverage to help pay for the costs of care. Medicaid is typically limited to low-income individuals who are under the age of 21 or older than 65, pregnant, in families with dependent children, or disabled. To qualify, these individuals must also meet certain income and asset tests. Services provided by an area program must be ordered by a psychiatrist or PhD psychologist as part of an individualized treatment plan. Services can also be provided by a physician, psychologist, or clinical nurse specialist employed and supervised by a physician.
Children are also eligible for treatment provided in residential treatment centers.
Some services are excluded from coverage under federal law. Children s mental health visits are not limited, although prior approval must be obtained for some services. CAP waivers typically require that states show cost-neutrality in the Medicaid program. While North Carolina can not implement a CAP-program for people with severe and persistent mental illness under current federal law, the State does have considerable flexibility in its existing program to cover many of the services that would otherwise be offered in a CAP program. The instruments used vary according to disability and age.