North Carolina expanded Medicaid in December 2023, opening the door for hundreds of thousands of residents who previously did not qualify. If you live in North Carolina and have a low or moderate income, you may now be eligible for free or low-cost health coverage through NC Medicaid. This guide walks you through everything you need to know about eligibility, income limits, and the application process so you can get covered without delays.
For a broader look at programs available in the state, visit our North Carolina Benefits Overview.
Who Qualifies for NC Medicaid in 2026?
Thanks to Medicaid expansion, most adults ages 19 through 64 can qualify based on income alone. You do not need to have children, be pregnant, or have a disability. Working adults, part-time employees, gig workers, and self-employed individuals can all qualify as long as their household income falls within the limits.
Beyond expansion adults, these groups also qualify under different income thresholds:
- Children ages 0 through 18 qualify at higher income levels than adults
- Pregnant women qualify at higher limits, and coverage extends through 12 months postpartum
- Seniors age 65 and older may qualify for full Medicaid or other Medicaid programs
- People with disabilities may qualify through disability-based Medicaid with different rules
To be eligible, you must also:
- Live in North Carolina
- Be a U.S. citizen or have an eligible immigration status (lawful permanent residents, refugees, asylees, and certain other statuses)
- Have or apply for a Social Security number
Families with mixed immigration status can still apply. Applying for Medicaid will not affect anyone's immigration status or chances of becoming a permanent resident.
NC Medicaid Income Limits for 2026
Income limits depend on your household size and the category you fall into. All figures below are monthly amounts before taxes. These numbers are current through April 1, 2026, based on official NC DHHS guidelines.
Adults Ages 19 through 64 (Expansion Medicaid, 138% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 1 | $1,800 |
| 2 | $2,433 |
| 3 | $3,065 |
| 4 | $3,697 |
Children Ages 0 through 18 (Up to 216% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 2 | $3,719 |
| 3 | $4,688 |
| 4 | $5,787 |
Pregnant Women (Up to 201% FPL)
| Household Size | Monthly Income Limit |
|---|---|
| 2 (pregnant individual counted with unborn child) | $3,455 |
| 3 | $4,353 |
| 4 | $5,250 |
Seniors Age 65 and Older
| Household Size | Full Medicaid | Other Medicaid Programs |
|---|---|---|
| 1 | $1,305/month | $1,761/month |
| 2 | $1,763/month | $2,380/month |
Important note about assets: Expansion adults (ages 19 through 64) have no asset limit. You can own a home, a car, and have savings without it affecting eligibility. Seniors and people qualifying through disability-based Medicaid face a $2,000 asset limit for individuals or $3,000 for married couples. Your primary home and one vehicle are typically exempt from asset calculations.
Not sure if you qualify? Use our free benefits screener to check your eligibility for Medicaid and other programs in just a few minutes.
How to Apply for Medicaid in North Carolina: Step by Step
You can apply for NC Medicaid at any time of year. There is no limited enrollment period. North Carolina offers four ways to submit your application.
Option 1: Apply Online Through ePASS (Recommended)
The fastest way to apply is through North Carolina's online portal called ePASS (Electronic Pre-Assessing Screening Service).
- Go to epass.nc.gov
- Create an NCID account if you do not already have one. This is a secure login used across North Carolina government programs.
- Select "Medical Assistance" on the application. This is what NC Medicaid is called in ePASS.
- Fill out the application with your personal information, household details, income, and any other requested information.
- Upload supporting documents such as pay stubs, proof of residency, and identification.
- Sign and submit your application electronically.
You can also apply through HealthCare.gov, which will route your application to NC Medicaid if you appear eligible.
Option 2: Apply In Person at Your Local DSS Office
Every county in North Carolina has a Department of Social Services (DSS) office where you can apply in person.
- Find your local DSS office using the NCDHHS directory or by calling 1-888-245-0179.
- Walk in or schedule an appointment by calling ahead (scheduling is recommended to save time).
- Bring your documents including proof of income, residency, and identity.
- Complete the application with help from a caseworker if needed.
Option 3: Apply by Phone
Call your local DSS office to complete an application over the phone. Find your local office number through the NCDHHS directory or call the NC Medicaid Contact Center at 1-888-245-0179.
Option 4: Apply by Mail
- Download and print the application form from the NC DHHS website.
- Fill it out completely and sign it.
- Include copies of supporting documents (do not send originals).
- Mail or fax it to your local DSS office.
Documents You Will Need
Having your documents ready can speed up the application process. You do not need every item on this list to apply, and you should submit your application even if some documents are missing. Your local DSS will contact you if they need additional information.
Proof of North Carolina residency:
- Photo ID with your current address
- Utility bill, lease, or mortgage agreement
- Vehicle registration or employment documentation
Proof of income:
- Recent pay stubs (if employed)
- Most recent tax return
- Business records (if self-employed)
- Documentation of unemployment benefits, Social Security, or other income
Proof of identity and citizenship:
- Driver's license or state ID
- Birth certificate or U.S. passport
- Social Security card
- Immigration documents (if applicable)
Other helpful documents:
- Health insurance information (if currently covered)
- Pregnancy verification (if applicable)
- Proof of disability (if applicable)
What Happens After You Apply
After submitting your application, your local DSS office will review it. Here is what to expect:
- Processing time: North Carolina aims to process applications within 45 days (90 days for disability-based Medicaid). Many applications are processed faster.
- You may be contacted by a caseworker if additional information or documents are needed.
- Check your status by logging into your ePASS account or calling your local DSS office.
- If approved, you will receive a Medicaid ID card and information about your health plan. Coverage can be retroactive up to three months before your application date if you were eligible during that time.
- If denied, you have the right to appeal. The denial notice will include instructions on how to request a hearing.
What NC Medicaid Covers
NC Medicaid provides comprehensive health coverage including:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Preventive care and screenings
- Mental health and substance use treatment
- Lab tests and X-rays
- Emergency room visits
- Maternity and newborn care
- Dental and vision care for children
- Emergency dental care for adults
- Long-term care services for those who qualify
Most NC Medicaid beneficiaries are enrolled in a managed care health plan, which means you will choose a primary care provider and get referrals for specialist care through your plan.
Renewing Your NC Medicaid Coverage
NC Medicaid coverage is not permanent. You must renew each year to keep your benefits. The state will send you a renewal notice before your coverage period ends. You can renew through ePASS, by mail, or by contacting your local DSS office.
Keep your contact information updated in ePASS so you do not miss renewal notices. If you miss your renewal deadline, your coverage may lapse and you will need to reapply.
Frequently Asked Questions
Can I apply for NC Medicaid if I am working?
Yes. Many working adults qualify for NC Medicaid under expansion. As long as your household income falls below the limits listed above, you are eligible regardless of employment status.
How long does it take to get approved?
Most applications are processed within 45 days. If your application requires additional documentation or involves disability-based Medicaid, it may take up to 90 days.
Can I apply for my children even if I do not qualify myself?
Absolutely. Children have higher income limits than adults. Even if your income is too high for adult Medicaid, your children may still qualify. Families with mixed immigration status can also apply for eligible members.
Is there a cost for NC Medicaid?
NC Medicaid is free for most beneficiaries. There are no monthly premiums, and most services have no copays. Some services may have small copays for certain groups, but providers cannot deny care if you are unable to pay.
Can I get Medicaid if I am undocumented?
Undocumented immigrants do not qualify for full NC Medicaid. However, emergency Medicaid may cover emergency medical situations. Contact your local DSS office to learn more about what is available.
What is the difference between NC Medicaid and Health Choice?
Health Choice is North Carolina's Children's Health Insurance Program (CHIP). It covers children in families that earn too much for Medicaid but still need affordable health coverage. When you apply through ePASS, the system will automatically determine which program your child qualifies for.
Can coverage start before my application date?
Yes. NC Medicaid can provide retroactive coverage for up to three months before your application date, as long as you were eligible during that time and had qualifying medical expenses.
Get Started Today
Applying for Medicaid in North Carolina is free and available year-round. The quickest route is through the ePASS online portal, but you can also visit your local DSS, call, or mail an application.
Not sure if Medicaid is the right fit? You might also qualify for SNAP, LIHEAP, WIC, or other programs. Check all your benefits at once with our free screener and find out what you are eligible for in just a few minutes.
For more information, contact the NC Medicaid Contact Center at 1-888-245-0179 (TTY: 711) or visit medicaid.ncdhhs.gov.
