NC Medicaid Eligibility

Basic eligibility requirements

• 1

  NC Medicaid may be available to people who are:

  • Low-income individuals and families
  • Age 65 or older
  • Blind or disabled
  • Infants and children under the age of 21
  • Pregnant
  • In need of long-term care
  • Receiving Medicare

  You also must:

  • Be a U.S. citizen or show proof of eligible immigration status
    (Some non-U.S. citizens can also get health care coverage through Medicaid. If you are applying for only emergency services, you are not required to provide documentation of immigration status.)
  • Live in North Carolina and show proof of residency
  • Have a Social Security number or show you have applied for one

  You are automatically eligible for Medicaid if you receive any of the following:

  • Supplemental Security Income (SSI)
  • State/County Special Assistance for the Aged or Disabled
• 2

  Income

  There are limits to how much money your family can make to be eligible for NC Medicaid. The income limits are based on your age, health needs and family size. Income limits are updated each year on April 1.

  Check the section that best describes you and your family:

  Accordion

  • You are applying for children ages 18 or younger
  • You are a parent or caretaker/relative with children ages 18 and under
  • You are ages 19 through 64
  • You are age 65 or older
  • You are pregnant, or were pregnant in the last 12 months
  • You have a disability or are blind

  Tab/Accordion Items

  You are applying for children ages 18 or younger

  Family Size	Income Limit, Before Taxes
  1	$2,649/month or less
  2	$3,595/month or less
  3	$4,541/month or less
  4	$5,486/month or less
  5	$6,432/month or less

  Your “family size” includes you, your spouse, and children under age 21 living with you and under your care. Include anyone else listed on your federal income tax return (dependents), if applicable.

  If the family income is over the limit, you may qualify for Medicaid under another program or you may qualify and have a Medicaid deductible.

  You may still qualify even if your income is more than these limits. The best way to find out is to apply for NC Medicaid.

  You are a parent or caretaker/relative with children ages 18 and under

  Medicaid provides medical coverage for parents or other caretakers/relatives with children ages 18 and under in the household. Additionally, NC Medicaid provides medical coverage for children ages 19 and 20. A pregnant woman also may qualify.

  Family Size	Income Limit, Before Taxes
  1	$434/month or less
  2	$569/month or less
  3	$667/month or less
  4	$744/month or less
  5	$824/month or less

  Your “family size” includes you, your spouse, and children under age 18 living with you and under your care. Include anyone else listed on your federal income tax return (dependents), if applicable.

  If the family income is over the limit, you may qualify for Medicaid under another program or you may qualify and have a Medicaid deductible.

  You are ages 19 through 64

  Family Size	Income Limit, Before Taxes
  Single adult	$1,732/month or less
  2	$2,351/month or less
  3	$2,970/month or less
  4	$3,588/month or less
  5	$4,207/month or less
  6	$4,286/month or less

  Your “family size” includes you, your spouse, and children under age 18 living with you and under your care. Include anyone else listed on your federal income tax return (dependents), if applicable.

  You are age 65 or older

  Family Size	Income Limit, Before Taxes	Asset Limit
  Single adult	$1,255/month or less	$2,000 or less
  2	$1,704/month or less	$3,000 or less

  
  Your “family size” includes you and your spouse.

  “Assets” include retirement accounts, stocks and bonds, the cash value of life insurance policies and other investments.

  You may still qualify even if your income is more than these limits. The best way to find out is to apply for NC Medicaid.

  You are pregnant, or were pregnant in the last 12 months

  Medicaid for Pregnant Women (or Pregnancy Medicaid) is a Medicaid program for pregnant women who do not have medical insurance or are underinsured. The program helps pregnant women get prenatal (before childbirth) and postpartum (after childbirth care). 

  A pregnant woman may apply for this program before or after she has her baby. A woman who has had a recent pregnancy loss may also be eligible. The coverage for the mother continues for 12 months after the birth event, including miscarriages, live birth, and stillborn. 

  Individuals who are eligible will get full Medicaid benefits.

  Family Size (Including Unborn Child)	Income Limit, Before Taxes
  2	$3,339/month or less
  3	$4,218/month or less
  4	$5,096/month or less
  5	$5,975/month or less

  Your “family size” includes you, your spouse, and children under age 21 living with you and under your care. The unborn child should be included in the family size. Also include anyone else listed on your federal income tax return (dependents), if applicable.

  You may still qualify even if your income is more than these limits. The best way to find out is to apply for NC Medicaid.

  You have a disability or are blind

  You are automatically eligible for NC Medicaid if you receive either: 

  • Supplemental Security Income (SSI) or
  • State/County Special Assistance for the Aged or Disabled.

  If you do not receive either of these, you may be able to get a disability determination.