Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
Search Saved

North Carolina program

Medicaid without counting parents’ income (CAP/C)

CAP/C adds home and community support for children who need a high level of care. It can also leave parents’ income out of the Medicaid test.

What it is

CAP/C adds home and community support for children who need a high level of care. It can also leave parents’ income out of the Medicaid test.

CAP/C can open Medicaid when parents earn too much and can add waiver services for a child who already has Medicaid. A clinical assessment must establish the required level of care and the need for a CAP/C service; an available place and the county’s eligibility review are also required.

Eligibility rules
  • Your child must be under 21 and need institutional-level care, assessed with a Service Request Form.
  • A case manager must find a need for at least one CAP/C home service. Parents’ income and resources are excluded from the approval month.
What you get
  • Full Medicaid based on the child’s own income.
  • Approved nursing, aide help and home supports.
  • Up to 40 paid hours weekly for a parent giving qualifying extraordinary care.
What the help covers
  • A case manager builds the service plan. Home modifications and other waiver supports need approval.
  • CAP/C is not a standard monthly-premium buy-in. County DSS checks your child’s own income and resources and whether a monthly Medicaid deductible applies. The social worker can help obtain that written budget so the family knows about any amount that must be met before coverage pays.
If you decide to apply
  1. Ask the hospital social worker or county to send a referral to NCLIFTSS at 833-522-5429.
  2. Gather the discharge plan, insurance cards and letters describing care needed day and night.
  3. Explain whether going home depends on these services.

NC Medicaid, through NCLIFTSS (Acentra Health) and a county case-management agency: 833-522-5429 · Official page ↗

If you decide to apply
  • The referral can also be faxed to 833-470-0597. The county case-management agency assesses services after referral.
  • NC LIFTSS at 833-522-5429 or the county CAP/C agency confirms the current wait and referral status. Your social worker can ask whether urgent circumstances qualify for priority consideration. A reserved place does not guarantee immediate approval or an available caregiver.
Good to know

A child who already has Medicaid may still need CAP/C’s extra services. A care assessment, financial review and available place are required.

Other details
  • Places are limited and there is a waiting list. A few places each year are held for emergencies; ask whether a discharge that depends on these services counts.
  • North Carolina has no separate Katie Beckett program; CAP/C is the route that leaves parents' income out.
Official sources
Ask your social worker

“Could our child’s care needs qualify for CAP/C, and what would it add or complicate? If a referral makes sense, could you help with the care assessment and any discharge priority?”

Why I’m asking: I want to know whether our child’s care needs open Medicaid without counting our earnings.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the referral, keep the discharge date in front of them, and gather the letters that describe the care the child needs at home.

Your social worker

The hospital social worker sends the referral and writes why going home depends on it; the case manager builds the service plan.

The care team

The oncology team writes the level-of-care letter: nursing hours, the line, feeds, oxygen and how often.

Who decides
NC Medicaid decides the level of care from the Service Request Form; the county case-management agency does the assessment.
Ask your social worker
“Can we refer today to the Community Alternatives Program for Children, ask for the emergency place because discharge depends on it, and hear about paid caregiving under consumer direction?”

How to apply

First step: Ask the hospital social worker to refer you to NCLIFTSS on 833-522-5429 this week.

  1. Ask the hospital social worker to send a CAP/C referral this week, and say plainly if going home depends on it.
  2. Ask the oncology team to write what the child needs at home in the words the level-of-care form uses.
  3. Ask the case manager about consumer direction and paid caregiving if you are giving the extraordinary care yourself.

Official application / program page ↗

Where it starts: Ask the hospital social worker or the county to send a CAP referral to NCLIFTSS on 833-522-5429, or fax the CAP/C and CAP/DA Referral Request to 833-470-0597.

What to gather

  • Letters from the oncology team describing the care the child needs at home
  • The discharge plan and date
  • The child’s own income, if any
  • Insurance cards

How long: No measured wait was published. Ordinary requests are first come, first served; emergency places exist for a child at risk of imminent, significant harm.

What a yes looks like

A case manager is assigned, a service plan is written, and Medicaid starts on the child’s own income from the month of approval.

What a no looks like, and the next move

Ask whether the no was on the level of care or on capacity. If it was capacity, ask to be considered again and ask about the emergency reserve.

Watch out

  • Places are capped and ordinary requests are first come, first served. Ask early.
  • Say plainly if going home from hospital depends on it: there are emergency places and a transition priority.
  • Nobody should tell you North Carolina has no Katie Beckett option. That document could not be read, so it is unknown.

Dates that change this

2023-03-01: The capacity figures come from the approved 2023 waiver, which is the document the state still links; a newer approval was not found. They are the number of places allowed, not the number of people waiting. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Full Medicaid decided on the child’s own income, plus nursing and aide hours at home. Places are capped at 5,500 a year.

  • $5,500/year — People the approved waiver allows in a year
  • $5,450/year — People the waiver allows to be enrolled at one time
  • $30/year — Places kept each year for a child at risk of imminent, significant harm
  • $40/week — Hours a week a parent can be paid for extraordinary care under consumer direction

Covers: Full North Carolina Medicaid for the child · Skilled nurse care at home · In-home aide help with daily living · Case management through a county agency · Home modifications and other waiver supports as approved

Legal protection: Parents’ income and resources are not counted from the month of approval

What it costs the family: Whether the waiver charges a premium could not be read: the approved application showed both yes and no labels. Ask the case manager.

The eligibility facts, as published

Age
0 through 20
Age max exclusive
21
Medical
must need a level of institutional care under the state plan, measured on a Service Request Form
Service test
needs at least one CAP/C home and community-based service, assessed by a CAP/C case manager
Income
the child’s own income only; no parent-for-child responsibility, from the month of CAP approval (MA-2280)
Capacity
5,500 a year and 5,450 at once under the approved waiver; 30 emergency places, 5 Money Follows the Person, 15 for displaced military families
Waiting list
unknown: no current statewide count or measured wait was published

Decisions this site cannot make: Level-of-care decision on the Service Request Form · Financial eligibility on the child’s own income from the month of approval

Expect friction on: Places are capped and ordinary requests are first come, first served · No current waiting-list count was published

The trap: Places are capped: the approved waiver allows 5,500 people a year and 5,450 at one time. Ordinary requests are first come, first served, so ask for the referral early rather than waiting to see how treatment goes. There are 30 emergency places a year for a child at risk of imminent, significant harm, and the priority language covers a child coming home from hospital, so say plainly if discharge depends on it.

Where I read this

← Back to your options