Medicaid in North Carolina provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. It is managed by the North Carolina Department of Health and Human Services (NCDHHS). NCDHHS website: https://medicaid.ncdhhs.gov/ Medicaid Questions: Call 1-888-245-0179.
Medicaid is a joint federal and state program that provides free or low-cost health coverage to eligible North Carolinians. The program is managed by the North Carolina Department of Health and Human Services (NCDHHS).
NC Medicaid provides coverage to more than 3 million North Carolinians—more than 1 in 4 residents—including children, older adults, people with disabilities, pregnant women, and working adults with lower incomes.
On December 1, 2023, North Carolina expanded Medicaid to cover more people. Since then, over 690,000 newly eligible North Carolinians have enrolled—far exceeding initial projections.
Who Can Now Qualify:
• Adults ages 19-64 with incomes up to 138% of the federal poverty level
• Single individuals earning approximately $20,000/year or less
• Families of three earning approximately $34,000/year or less
This expansion covers working adults, college students, childless adults, veterans, and workers in industries like construction, hospitality, childcare, and home health care.
NC Medicaid covers several groups, each with different income limits:
• Children (ages 0-5): Families with incomes up to 215% of the federal poverty level
• Children (ages 6-18): Families with incomes up to 216% FPL
• Pregnant women: Incomes up to 201% FPL (coverage continues 12 months postpartum)
• Adults ages 19-64: Incomes up to 138% FPL (Medicaid expansion)
• Elderly adults and individuals with disabilities: Various income and resource requirements
• Family Planning Medicaid: Reproductive health coverage for incomes up to 195% FPL
You can apply for NC Medicaid year-round through several methods:
Online: Apply through ePASS at epass.nc.gov or through HealthCare.gov
In Person: Visit your local Department of Social Services (DSS) office
By Phone: Contact your local DSS office
By Mail: Download and mail a paper application
Applications can take up to 45 days to process. Online applications may be processed faster.
For eligibility questions:
NC Medicaid Contact Center: 1-888-245-0179
Visit: medicaid.ncdhhs.gov
For help choosing or changing your health plan:
NC Medicaid Enrollment Broker: 1-833-870-5500 (TTY: 711)
Visit: ncmedicaidplans.gov
For problems with your coverage:
NC Medicaid Ombudsman: 1-877-201-3750
Free enrollment assistance:
NC Navigator Consortium: 1-855-733-3711 or ncnavigator.org
If your income is too high for Medicaid, you may qualify for subsidized health insurance through the ACA marketplace (HealthCare.gov). Our licensed agents at Health Plans of NC can help you explore these options at no cost.