Non-Citizen Medicaid Notice H.R. 1 English

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IMPORTANT INFORMATION ABOUT YOUR NC MEDICAID COVERAGE STARTING OCTOBER 1, 2026

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A new federal law is changing the rules for Medicaid.
You are getting this letter because our information shows
the person(s) below will lose NC Medicaid coverage.

Dear «Header.addresseeName»:

Who will lose health care coverage

On October 1, 2026, the person(s) listed in this letter will lose Medicaid coverage if they have any of these immigration statuses:

  • Refugee
  • Asylee
  • Trafficking survivor
  • Other humanitarian statuses that will no longer be qualified under the new federal law
Person(s) who will lose health care coverage
Name ID number DOB
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See the last page of this letter for a full list of immigration statuses that will lose health care coverage.

Immigration/Citizenship statuses that will keep Medicaid coverage October 1, 2026

On October 1, 2026, only the following citizen and immigration statuses (“qualified” statuses) will keep their Medicaid coverage:

  • U.S. citizens and U.S. nationals
  • Lawful permanent residents (green card holders)
  • Cuban and Haitian entrants
  • Compacts of Free Association (COFA) migrants which are citizens of the Federated States of Micronesia, the Marshall Islands and the Republic of Palau.

What does this mean for your Medicaid

Starting October 1, 2026, if your immigration status is not a “qualified” status, you

  • Will lose Medicaid coverage, including doctor visits, prescriptions, mental health, dental and other services.
  • May qualify for Emergency Medicaid if you get emergency medical care.

These changes do not include lawful permanent residents (green card holders). If you are a lawful permanent resident, these changes will not apply to you.

If you lose Medicaid coverage and have a medical need on or after October 1, 2026, you can reapply for Medicaid.

What you need to do now

Check your mail carefully. Respond right away if your local Department of Social Services sends you a letter asking for information about your immigration status.

If you are currently a lawful permanent resident, let your local Department of Social Services know as soon as possible. You should also update your immigration status with your local Department of Social Services caseworker if it changes (you become a lawful permanent resident).

Remember, if your immigration status changes, for example, you get a green card, let your local Department of Social Services know as soon as possible so you do not lose Medicaid coverage.

Resources and help

Contact your local «DSSCountyName» Department of Social Services at «DSSPhoneNumber» if:

  • You get a letter from your local Department of Social Services asking for information
  • Your immigration status changes
  • You have questions about your current status or Emergency Medicaid

Call the NC Medicaid Contact Center at 1-888-245-0179 if you need help finding your local Department of Social Services.

Visit https://medicaid.ncdhhs.gov/HR1 or scan the QR code to visit NC Medicaid’s webpage on these changes:

QR code linking to NC Medicaid webpage

Immigration statuses that will lose Medicaid coverage on October 1, 2026:

  • Refugees
  • Asylees
  • Victims of Trafficking (including certain family members)
  • Parolees (including Ukrainian Humanitarian Parolees and Afghan Parolees)
  • Non-citizens with Deportation Withheld
  • Non-citizens Granted Conditional Entry
  • Amerasian Non-citizens
  • American Indians born in Canada or outside of the U.S. (including federally recognized tribal members that are not U.S. citizens)
  • Battered Non-citizens (including spouse, parents and children)
  • Lawfully Residing Veterans/Active-duty Service Members (including certain family members)
  • Non-citizens with Iraqi or Afghan Special Immigrant Visas (including spouse and children)
  • Hmong, Mien or Highland Laotian Non-citizens (including spouse and children)
  • Applicants for Permanent Residence, Asylum or Temporary Protected Status
  • Other Lawfully Residing Non-citizens
On