CAP/C Services in North Carolina

North Carolina’s Children with Disabilities and Special Health Care Needs (CAPC) program offers vital financial assistance to families raising children with significant medical needs — helping cover costs that insurance often won’t.

What CAPC Is and Who It Serves

• CAPC (Child and Adolescent Populations with Chronic Conditions) is a state-funded program administered by NC DHHS to support families of children with special health care needs.
• Children must be under 21 years old and have a diagnosed chronic or disabling condition to qualify.
• The program is designed for families who earn too much for Medicaid but still struggle with high out-of-pocket medical costs.
• Both insured and uninsured children may be eligible, depending on income and diagnosis.

What Costs CAPC Can Help Cover

• Medical appointments and specialist visits related to your child’s qualifying condition.
• Prescription medications that are part of your child’s treatment plan.
• Durable medical equipment such as wheelchairs, braces, or communication devices.
• Therapies including physical, occupational, and speech therapy sessions.
• Transportation costs to and from medical appointments in some cases.

How to Apply for CAPC

• Contact your local county health department — they are the entry point for CAPC enrollment in North Carolina.
• Ask specifically for the Children’s Developmental Services Agency (CDSA) or CAPC coordinator in your county.
• Gather documents including proof of income, your child’s diagnosis records, and insurance information before your first meeting.
• A caseworker will complete a financial and medical eligibility review — be honest and thorough so nothing is missed.
• You can also call NC DHHS at 1-800-737-3788 to ask questions before applying.

Tips for Making the Most of CAPC

• Keep a dedicated folder of all medical bills, EOBs, and receipts — CAPC may reimburse costs already paid.
• Ask your CAPC coordinator about other programs you may qualify for simultaneously, such as NC Innovations Waiver or Health Choice.
• Re-enroll on time each year — eligibility must be renewed annually and gaps can interrupt coverage.
• If a service is denied, you have the right to appeal the decision — ask your coordinator to walk you through the process.

Finding Local Support and Resources

• The Family Support Network of NC (fsnnc.org) connects parents with local navigators who know CAPC inside and out.
• Exceptional Children’s Assistance Center (ECAC) offers free parent training and can help you advocate for full benefits.
• Search the NC 211 helpline (dial 2-1-1) to find county-specific CAPC contacts and complementary local programs.