Questions and Answers about Medicaid Expansion

You can apply online, in person, over the phone or by mail. Learn more about how to apply, including what documents you need and how long it usually takes to get a decision.

• Physical Address: You do not need a physical address to apply for Medicaid. However, you must confirm you are physically in North Carolina and plan to live here. You do not need to plan to stay permanently and do not need to have a fixed address.
• Mailing address: If you do not have a mailing address, enter an address where you can pick up mail or enter the address of your local DSS office. Find a local Department of Social Serivces (DSS) near you.
• Email address: You must have an email address to apply online. If you do not have an email address, you may apply in person at your local DSS office, by phone or by paper application.

The date coverage begins depends on when you apply for Medicaid. 

You can request your Medicaid coverage be retroactive for up to three months from the application date. Be sure to answer the questions about medical bills from prior months on your Medicaid application. 

For example: If you apply in March 2024 and you are eligible, Medicaid can pay bills for covered services from December 2023, January 2024 and February 2024.

The online Medicaid application through ePASS is currently only available in English and Spanish. To view ePASS in Spanish, click “Español” near the upper lefthand corner.

However, all local Department of Social Services (DSS) can connect you to a language line to provide help in other languages. Free language assistance and/or other aids and services are available upon request. To receive free interpreter services or communication assistance, call your local DSS [link to DSS directory] and ask the operator for an interpreter. To receive free interpreter services or communication assistance, call your local DSS and ask the operator for an interpreter. 

Some non-U.S. citizens can get health coverage through Medicaid. To be eligible you must live in North Carolina and be a non-citizen with qualified immigration status. Many people in this category must wait five years before they can apply for Medicaid, although there are some exceptions, as explained below.

Qualified immigration status includes:

• Lawful Permanent Residents (LPR/Green Card Holder)
• Asylees
• Refugees
• Cuban/Haitian entrants
• Paroled into the U.S. for at least one year
• Conditional entrant granted before 1980
• Battered non-citizens, spouses, children or parents (“Battered” means someone who has experienced abuse from a family member.)
• Victims of trafficking and their spouse, child, sibling or parent or individuals with a pending application for a victim of trafficking visa
• Granted withholding of deportation (a specific situation similar to asylum)
• Non-citizen members of a federally recognized Indian tribe or American Indian born in Canada
• Citizens of the Marshall Islands, Micronesia and Palau who are living in one of the U.S. states or territories (referred to as Compact of Free Association or COFA migrants)

Some of the non-U.S citizens on the list above do NOT have to wait 5 years to be eligible for Medicaid. Those who do not have to wait five years for Medicaid eligibility include pregnant women, children under the age of 19, asylees, refugees, victims of trafficking, Cuban-Haitian Entrants and people who now have LPR status and who were previously asylees, refugees, victims of trafficking or Cuban-Haitian entrants. Also, all non-citizens from the list above who are connected to the military such as veterans, active-duty military (and their spouses and children) do not have to wait five years for Medicaid eligibility. All other non-citizens in the list above must wait five years from the time of receiving their qualified immigration status to be eligible for Medicaid.

If none of the qualified immigration statuses listed above apply to you:

If you are not a U.S. citizen or part of these immigration categories, but you would otherwise qualify for NC Medicaid, you may still apply to get emergency coverage that includes:

• Payment for the costs of childbirth. Get coverage for medical costs during labor and delivery. You can apply up to three months after birth.
• Payment for emergency services. Get coverage for the medical costs of treating an emergency, like a heart attack, stroke or serious accident. You can apply up to three months after the emergency.

To get this emergency coverage, apply for NC Medicaid as normal—but you do not need to show documentation or answer questions about your immigration status.

Medicaid does not report any information to law enforcement or Immigration and Customs Enforcement (ICE). Your information will be kept private and confidential. This includes information for your family members with different immigration statuses. Your information cannot be used for immigration enforcement purposes.

You only need to provide immigration status or Social Security numbers for family members who are applying for coverage. For instance, a parent who is not an eligible immigrant could apply on behalf of a child who is eligible. The parent would not need to provide their own immigration status.

For more information on health insurance eligibility for immigrants, read this brochure from the NC Justice Center.

No. Applying for or receiving Medicaid does not make someone a “public charge”. It will not affect your immigration status or your immigration application. Only three benefits are considered negatively if you are submitting an immigration application: Supplementary Security Income (SSI), Temporary Assistance for Needy Families (TANF) and Medicaid only if used for long-term hospitalization or nursing home care. All other benefit and health programs are safe to use and have no impact on any immigration application you file. For more information on public charge, read this informational flyer from the NC Justice Center.

Undocumented immigrants are eligible for emergency Medicaid. However, undocumented immigrants are not eligible to enroll in federally funded health coverage including full Medicaid, CHIP or Medicare, or to purchase coverage through the Federal Marketplace. Undocumented immigrants are only potentially eligible for emergency Medicaid or labor and delivery services. 

Everyone is potentially eligible for emergency Medicaid as long as they meet the income and North Carolina state residence eligibility requirements (provide proof they live in North Carolina, such as photo ID with your address, a utility bill, a lease or documentation of employment). Undocumented non-U.S. citizens who do not qualify for full health coverage under Medicaid may be able to get coverage for emergency medical services. North Carolina has a state emergency medical review contractor who determines if the incident is a medical emergency and determines the dates that Medicaid could cover. The coverage is limited to certain dates, beginning with the date the medical emergency occurs and ending with the date the medical emergency is stabilized. For example, when someone is in a car accident and taken to the emergency room or women who give birth and do not have insurance. 

Undocumented, non-U.S citizen pregnant women may be eligible for emergency services covering labor and delivery if they meet the income and state residence eligibility requirements. However, they are not eligible to receive full Medicaid benefits.

All applicants must meet state residence and income requirements. Parents can apply for themselves and/or their children.

• Parents who do not have a valid immigration status are eligible for emergency services only.
• Their children may be eligible for full Medicaid if they have a qualified immigration status. This is true even if their parents do not have qualified immigration status.

If only one family member is applying for insurance or assistance, only the applicant(s) must provide immigration status information or their social security number. Other family members who are not applying do not have to provide immigration information.

Parents who apply for their eligible children need to give the names of all members in their household, their mailing address, any verification of any income and proof of state residency from the parent(s) to determine the child’s eligibility along with a signed application. Parents do not need to give immigration information or a social security number for themselves if they are not applying for Medicaid for themselves. Medicaid does not report any information to law enforcement or ICE.

To apply for an adult child 18 and older, a parent must be designated as an Authorized Representative. An Authorized Representative is an individual who is legally authorized or designated in writing by the person applying to act on their behalf. Only an Authorized Representative can complete a Medicaid application for someone else. Additionally, your local Department of Social Services (DSS) must complete a medical evaluation and request medical records to be reviewed by Disability Determination Services (DDS). If you need help, you can contact your local DSS office so they can guide you through the application process. The Authorized Representative does not have to be a parent. An adult with disabilities may designate anyone as their Authorized Representative.

No, people with TPS cannot apply for full health coverage through Medicaid. However, they may be eligible for emergency Medicaid as long as they meet the income and North Carolina state residence eligibility requirements. Pregnant women and children under 19 with TPS are eligible to apply for Medicaid if they meet all other eligibility requirements and are not subject to the five-year wait period. People with TPS can apply for coverage and help paying for insurance under the Health Care Marketplace (ACA).

No. Under rules issued by the Centers for Medicare and Medicaid Services (CMS), people with Deferred Action for Childhood Arrivals status are not considered lawfully present for purposes of health coverage eligibility. People with DACA are eligible for emergency Medicaid services when needed.

Farmworkers with a lawfully present status are potentially eligible if they are a pregnant woman or child under age 19. All other individuals are eligible to receive emergency Medicaid services. People with an H-2A visa can apply for coverage and help paying for insurance under the Health Care Marketplace (ACA).

They are potentially eligible and exempt from the five-year bar if they are a pregnant woman or child under age 19. Non-pregnant adults who are 19 and older are only eligible for emergency Medicaid services. People applying only for emergency services are not required to provide documentation of immigration status. People with non-immigrant visas who are residents of North Carolina can apply for coverage and help paying for insurance under the Health Care Marketplace (ACA).

No. They would only potentially qualify for emergency services Medicaid.

If you need to reset your password or unlock your account:

• Go to ncid.nc.gov.
• Choose the link under the NCID login that you need:
  • Forgot Password 
  • Unlock Account 
• Enter your username and follow the directions.

If you need help, call the North Carolina Department of Information Technology Service Desk at 800-722-3946.

• Physical Address: You do not need a physical address to apply for Medicaid. However, you must confirm you are physically in North Carolina and plan to live here. You do not need to plan to stay permanently and do not need to have a fixed address.
• Mailing address: If you do not have a mailing address, enter an address where you can pick up mail or enter the address of your local DSS office. Find a DSS office near you at ncdhhs.gov/localdss.
• Email address: You must have an email address to make an NCID and use ePASS. If you don’t have an email address, you may apply at your local DSS office, by phone or by paper application.