North Carolina Expands Medicaid
North Carolina has expanded health care coverage to more people.
NC Medicaid now covers people ages 19 through 64 years with higher incomes. You may be able to get health care coverage through Medicaid even if you did not qualify before. NC Medicaid pays for doctor visits, yearly check-ups, emergency care, dental care, mental health and more – at little or no cost to you.
Most people can get health care coverage through NC Medicaid if:
- You live in North Carolina
- You are ages 19 through 64 years old
- You are a citizen (some non-US citizens can also get health care coverage through Medicaid).
- And if your household income falls within the chart below:
Household size | Monthly income, before taxes |
---|---|
Single Adults | $1,732/month or less |
Family of 2 | $2,351/month or less |
Family of 3 | $2,970/month or less |
Family of 4 | $3,588/month or less |
Family of 5 | $4,207/month or less |
Family of 6 | $4,286/month or less |
If someone is pregnant, they may be eligible for other Medicaid programs to get full health benefits.
NC Medicaid covers most health services. It includes doctor visits, check-ups, emergency care, hospital services, maternity and postpartum care, vision and hearing services, prescription drugs, behavioral health, preventive and wellness services, dental care, medical-related devices and more. There is no monthly fee and copays are never more than $4.
For questions or information:
- NC Medicaid expansion, including who is eligible, benefits, enrollment and more: Questions and answers about Medicaid expansion
- If you are eligible for NC Medicaid: Check our eligibility guidelines or contact your local Department of Social Services (DSS).
- Standard Plan benefits or to change your primary care provider (PCP): Call your Standard Plan:
- WellCare: 1-866-799-5318 (TTY: 711)
- UnitedHealthcare Community Plan: 1-800-349-1855 (TTY: 711)
- HealthyBlue: 1-844-594-5070 (TTY: 711)
- AmeriHealth Caritas: 1-855-375-8811 (TTY: 1-866-209-6421)
- Carolina Complete Health: 1-833-552-3876 (TTY: 711 or 1-800-735-2962)
- To change your PCP if you are in NC Medicaid Direct: Call the NC Medicaid Contact Center at 1-888-245-0179.
- Your Local Management Entity/Managed Care Organization (LME/MCO) or Tailored Care Management (TCM): Call your LME/MCO:
- Alliance Health: 1-800-510-9132 (TTY: 711 or 1-800-735-2962)
- Partners Health Management: 1-888-235-4673 (TTY: 1-800-735-2962)
- Trillium Health Resources: 1-877-685-2415 (TTY: 711)
- Vaya Health: 1-800-962-9003 (TTY: 711)
- If you are a federally recognized tribal member or an IHS-eligible beneficiary with questions on Eastern Band of Cherokee Indians (EBCI) Tribal Option: Call the EBCI Tribal Option.
- EBCI Tribal Option: 1-800-260-9992 (TTY: 711)
- EBCI Tribal Option: 1-800-260-9992 (TTY: 711)
- Your health care options or changing your health plan: visit ncmedicaidplans.gov, use the NC Medicaid Managed Care mobile app, or call 1-833-870-5500 (TTY: 711 or RelayNC.com)
- If you need help with resources or to help you understand your rights and responsibilities: Call the NC Medicaid Ombudsman at 1-877-201-3750.
- For all other questions, check the NC Medicaid Beneficiary Help Center or call the NC Medicaid Contact Center at 1-888-245-0179.