Immigration Status and Eligibility for NC Medicaid

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New laws are changing the rules for who can get NC Medicaid, starting October 1, 2026. This page details the new rules.

Which Non-citizens Can Get NC Medicaid

Starting October 1, 2026

To get Medicaid if you are not a U.S. citizen, you must meet the regular Medicaid rules, such as age and income, and have one of these qualifying immigration statuses:

  • You have a green card. This is also called being a lawful permanent resident. Most people with a green card also have to wait 5 years. Read the next section.
  • You are a child under age 19 who is lawfully residing in the United States but does not have permanent immigration status.
  • You are pregnant, or you gave birth in the last 12 months, and you are lawfully residing in the United States but do not have permanent immigration status.
  • You have Cuban or Haitian entrant status.
  • You are a citizen of the Federated States of Micronesia, the Marshall Islands or the Republic of Palau, living in the United States. This is called being a COFA migrant.

If your situation is not listed here, you might lose your Medicaid starting October 1, 2026. If you are not sure, contact your local Department of Social Services (DSS).

Green Card Holders

Most lawful permanent residents (green card holders) must wait 5 years in the United States before they can become eligible for Medicaid.

There are exceptions to this 5-year wait. They include, but are not limited to, lawful permanent residents who:

  • Have 40 qualifying work quarters, or
  • Are a veteran or active-duty armed forces service member, or
  • Were admitted under an exempt status, such as Refugee, Asylee or other humanitarian status

Emergency Medicaid

Some non-citizens may still be able to get Emergency Medicaid, which can help pay for emergency care you get in a hospital emergency department.

Emergency Medicaid is not standard health coverage. It is a limited program used to cover the cost of emergency care they are legally required to provide under federal law, regardless of a patient’s immigration status. It only applies to true medical emergencies and only if the individual meets income and other rules.

No immigration documentation is required for Emergency Medicaid, as the care must be provided under federal emergency treatment laws.

Information Shared With The U.S. Government

The immigration information you give when you apply is shared with the Centers for Medicare & Medicaid Services (CMS). CMS shares this data with other federal government agencies based on federal laws and regulations.

Based on federal laws, the following information may be shared with U.S. federal government agencies:

  • Name
  • Address
  • Assigned Medicaid identification number
  • Social Security number
  • Date of birth
  • Sex
  • Phone number
  • Locality
  • Ethnicity

Even if you disenroll or cancel, NC Medicaid is required to share information with the federal government. The historical information cannot be removed or deleted.

You are not considered a “public charge” if you apply for or have Medicaid. This means that applying for NC Medicaid or having Medicaid will not hurt your chances of getting a Green Card (Lawful Permanent Resident Status), unless you use Medicaid for a long stay in the hospital or nursing home.

How to Apply for Family Members

You can apply for anyone in your family or household to get Medicaid, even if you cannot get it yourself. You only need to give immigration information or Social Security numbers for family members who need coverage.

For example, undocumented parents or guardians can apply for their children to get Medicaid. The parent does not need to give their own immigration status or a Social Security number when they apply.

If You Lose Your Medicaid

You will get a letter. It will explain why, and it will tell you how to appeal if you disagree. You usually have 60 days from the date on the letter. How to appeal a Medicaid decision

For free help with a notice or a bill, call the NC Medicaid Ombudsman at 1-877-201-3750. The Ombudsman isindependent of your local DSS.

These organizations may also be able to help:

If You Cannot Get NC Medicaid

If you cannot get full health care coverage through Medicaid because you are not a U.S. citizen, you might qualify for other health care coverage.

  • The Health Care Marketplace (ACA) offers health coverage or help paying for insurance for people with any kind of lawful status in the United States.
  • Federally Qualified Health Centers may offer services at a lower cost for people without insurance, regardless of immigration status. Find a center near you at hrsa.gov.
  • Local Departments of Social Services (DSS) can help connect you with health services and clinics. Find a DSS near you.
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This page was last modified on 09/01/2026