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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