Table of Contents
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
