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North Carolina Medicaid

North Carolina Medicaid is a health insurance program for certain low-income and needy people paid with federal, state, and county dollars.

North Carolina Medicaid is a health insurance program for certain low-income and needy people paid with federal, state, and county dollars. It covers more than 1 million people in the state, including children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments.

Program Name North Carolina Medicaid
Expanded Medicaid No
Website https://medicaid.ncdhhs.gov/
Phone 888-245-0179
Apply Online https://epass.nc.gov/
Appeal a Denial File an Appeal
Find a Local Office Local DSS Directory

Eligibility Requirements

To be eligible for North Carolina Medicaid, you must be a resident of the state of North Carolina, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:

  • Pregnant
  • Be responsible for a child 18 years of age or younger
  • Blind
  • Have a disability or a family member in your household with a disability
  • Be 65 years of age or older

Annual Household Income Limits (before taxes)

Household Size* Maximum Income Level (Per Year)
1 $17,131
2 $23,169
3 $29,207
4 $35,245
5 $41,284
6 $47,322
7 $53,360
8 $59,398

*For households with more than eight people, add $6,038 per additional person.

Available Services Include:

Adult care homes Maternity services
Ambulance services Mental health services
Chiropractic services Nursing facilities
Dental and orthodontic Orthotics and prosthetics
Durable medical equipment Outpatient specialized therapies
Family planning Physician services
Hearing services Podiatry services
Hospice services Prescription drugs
Hospital services Radiology services
Independent practitioner services Transportation services
Laboratory services Vision services

Copayments

Physicians $3
Outpatient services $3
Podiatrists $3
Generic and brand prescriptions $3
Chiropractic $2
Optical services $2
Optometrists $3
Emergency visit for non-emergency $3

There are no copays for the following members or services:

  • Members under age 21
  • Members who are pregnant
  • Members receiving hospice care
  • Federally recognized tribal members
  • North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) beneficiaries
  • Children in foster care
  • People living in an institution who are receiving coverage for cost of care
  • Behavioral health services

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