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Medical care special medical expense form

Medical care special medical expense form 2026

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The document is a Medical Care Special Expense Form from the North Carolina Division of Social Services, designed for Special Assistance beneficiaries to report monthly costs of prescribed medicines not covered by Medicaid or other insurance. It requires verification by a pharmacist and outlines instructions for completing the form, including the need to exclude co-payments and the process for reporting changes in medical expenses.

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