MMS STOP/GO preliminary screening

Take the Free Medicaid & FNS Assessment

Answer the questions below to receive possible North Carolina benefit pathways and suggested next steps. You do not need an MMS Connect account and your results are free.

Your screening is saved securely for MMS follow-up.

With your consent, MMS saves your contact information, answers, and results under Medicaid Screenings. Do not enter Social Security numbers, medical records, bank information, or document images.

Before you begin

Free results are provided immediately.

This screening is educational and is not an application or an official eligibility determination. County DSS or the appropriate government agency makes the final decision.

GO · Possible matchPAUSE · More information neededREVIEW · Professional or agency review suggested

1. About the applicant

First name Last name Email address Phone number Date of birth Current North Carolina county Lives in North Carolina or intends to remain here U.S. citizen or eligible immigration status

2. Current coverage and household

Currently receives Medicaid Has Medicare Part A Has Medicare Part B Receives SSI Pregnant Recently gave birth Household size Tax filing and household relationships are clear Married Spouse lives at home

3. Current monthly income and resources

Use estimates before taxes. Leave a money field blank if you do not know it.

Monthly wages Monthly net self-employment income Other monthly income Income expected to change soon Countable resources are known Estimated countable resources

4. Disability, work, and care needs

Formal disability determination Legally blind Currently working Current living arrangement Care setting being considered Needs daily help with personal care or safety Caregiver regularly available Nursing-facility level of care formally determined Required care assessment completed Lives in a PACE service area Assets transferred in the last five years

5. Special circumstances

Emergency Medicaid Breast or cervical cancer coverage Former foster care Refugee medical assistance Medicaid notice or appeal deadline Other specialized review

No account or payment is required. Enter at least an email address or phone number.