Se Habla Español 201 N. Breazeale Avenue | Mount Olive, NC 28365 919-658-4954 FAX 919-658-5754

 

Mon-Fri:
7:30am to 6pm

Please check in one hour
prior to closing

Sat: 8am to 12pm
(Walk-in Only)
Limited Staff and Services

Sun:
Closed

The Medical Access Program, or “MAP”, is a grant-funded program created to assist patients who are not eligible for Medicaid or other reimbursement programs and seek financial assistance with the cost of their medical care.

Eligibility Criteria:

  • Must have no Primary Health Care (Medical) coverage and meet certain financial criteria
  • Patients are expected to make Mt. Olive Family Medicine Center (MOFMC) their “primary care home” and to use it for their primary care needs. 
  • Established patients at MOFMC are also eligible. Benefits include assistance with outstanding MOFMC bills to those who qualify
  • Patients must reside and/or pay income taxes in North Carolina. 
  • Patients must bring proof of household income.
  • As of 12/01/2023: Patients must apply for NC Medicaid.  If denied for this coverage, proof of denial is required.

Items to Bring to Application Appointment:

  • Household Member Information
    • Names and ages of ALL individuals living in the household, including relatives and non-relatives
    • Documentation of the insurance of those individuals, if they are insured
    • Last employer and year worked for all individuals in the household
  • Proof of Income for ALL Members of Household ( One of the following for each employed member of the household)
    • Signed and dated past year’s completed tax form that was submitted to the IRS, or
    • Past year’s W-2 form(s), or
    • 3 most recent consecutive paycheck stubs, or
    • Letter(s) from employer(s) stating annualized income
  • Proof of any other income, including
    • Child support
    • Alimony
    • Unemployment
    • Social Security
    • Disability Benefits
  • If no income
    • Bring proof of expenses and how they are being paid. This can be in the form of a letter if someone is helping you financially.

Approval Information:

If you are approved, MAP will cover the majority of your medical visits. Depending on your income and the number of people in your household, you will be responsible for a copay ranging from $5.00 to $20.00. You will be informed of your copay during the application process. Copays are due at the time of service.

 

For an Application Appointment, please call: 919-581-4961 
 

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