NC Medicaid in North Carolina

NC Medicaid is North Carolina's Medicaid program — free or low-cost health coverage for low-income residents. It is administered by the NC Division of Medical Assistance (NCDHHS).

Who qualifies for NC Medicaid?

North Carolina covers adults 19–64 with income up to 138% of the Federal Poverty Level (FPL). Key qualifying groups include:

• Adults (19–64): Income up to 138% FPL (~$21,597/year single; ~$44,367/year family of 4)
• Children: Generally covered at higher income levels
• Pregnant women: Higher income limits apply
• Seniors and people with disabilities: SSI recipients qualify automatically

North Carolina expanded Medicaid in December 2023 — one of the most recent states to do so. Adults 19–64 earning up to 138% FPL now qualify. NC also has NC Health Choice for children above the Medicaid limit. If you were previously denied due to income, you may now qualify — apply again.

How to apply for NC Medicaid

You can apply through North Carolina's official portal, by phone, by mail, or in person at your local NC Division of Medical Assistance (NCDHHS) office.

• Online: Apply at ePASS NC →
• Processing time: Most applications are processed within 45 days (90 days for disability-based applications)
• Coverage start: If approved, coverage typically begins the first day of the month you applied
• Renewal: Medicaid eligibility is reviewed annually — respond to renewal notices to avoid losing coverage

What does NC Medicaid cover?

Medicaid in North Carolina covers a comprehensive set of services, including:

• Doctor visits and preventive care
• Hospital stays (inpatient and outpatient)
• Emergency services
• Mental health and substance use treatment
• Prescription drugs
• Lab tests and X-rays
• Prenatal care and delivery
• Long-term care (nursing home and home-based services)

Most services are covered at no cost or very low cost. Some plans may charge small copays for non-emergency services.

What documents do I need?

• Proof of identity (driver's license, state ID, or passport)
• Proof of North Carolina residency (utility bill, lease, or bank statement)
• Proof of income (pay stubs, tax returns, or employer letter)
• Social Security numbers for all household members applying
• Proof of citizenship or immigration status

Common questions about NC Medicaid

Can I keep my doctor on NC Medicaid?

NC Medicaid is often provided through managed care plans. When you enroll, you will choose a plan and a primary care provider. If your current doctor accepts NC Medicaid, you can stay with them. Call your doctor's office to confirm before enrolling in a plan.

What if my income changes?

Report income changes to NC Division of Medical Assistance (NCDHHS) within 10–30 days. If your income rises above the limit, you may qualify for marketplace coverage with subsidies instead — coverage is typically available without a gap.

Can I have both Medicaid and private insurance?

Yes. If you have employer coverage, NC Medicaid can act as secondary insurance, covering costs your primary insurance doesn't pay. This is called "dual coverage" and can significantly reduce your out-of-pocket costs.