Questions and Answers about Medicaid Expansion

Yes. Federal law allows states to expand who can get health coverage through Medicaid, known as Medicaid expansion. Since 2014, 40 states and Washington D.C. have expanded Medicaid.

Starting December 1, 2023, more North Carolinians can get health care coverage through Medicaid. NC Medicaid now covers people ages 19 through 64 years with higher incomes. Many North Carolinians who did not qualify for health coverage through NC Medicaid prior to December 1, 2023 may now qualify. Learn more about NC Medicaid eligibility.

The NC Medicaid Expansion Dashboard, updated monthly, tracks how many people are enrolled in NC Medicaid as a result of Medicaid expansion. View and filter by health plan, demographics, or county.

Health coverage through NC Medicaid is comprehensive. Because these services are covered by NC Medicaid, they are provided at no cost or low cost to you. Services include, but are not limited to:

• Primary care so you can go to a doctor for a check-up or when you are not feeling well
• Hospital services when you need to stay overnight (inpatient) or when you can go home the same day (outpatient)
• Maternity and postpartum care if you are pregnant and after giving birth
• Vision and hearing services
• Prescription drug benefits
• Behavioral health
• Preventive and wellness services
• Dental and oral health services
• Medical-related devices and other therapies

You do not have to pay any monthly premiums. Medicaid pays the cost for most health care services. The highest copay is $4 and that is only required for some services.

Most people can get health care coverage through NC Medicaid if they meet the criteria below.

You can get health care coverage through NC Medicaid if:

• You live in North Carolina,
• You are a citizen (some non-US citizens may qualify),
• And your household income meets the eligibility criteria

On December 1, 2023, North Carolina expanded Medicaid so more people can get health care coverage, including people ages 19-64. You may be eligible now even if you were not before. Learn more about NC Medicaid eligibility. Learn more about NC Medicaid eligibility.

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 a qualified immigration status. Learn more about NC Medicaid for non-U.S. citizens

Some people who have Medicare coverage may be eligible for Medicaid.

For example, people with a disability and under age 65 may be eligible for Medicaid through disability coverage. Contact your local Department of Social Services (DSS) to learn more.

Family Planning Medicaid provides reproductive health care at no cost to people with incomes up to 195% of the federal poverty line – that’s about $2,448 a month for a single person. It covers almost all methods of birth control, testing and treatment for sexually transmitted infections, preventive services and more.

To find out if you qualify for Medicaid, visit HealthCare.gov and update your Marketplace application or create a new one. After submitting your application, review your updated “Eligibility Results.”

You can also apply for NC Medicaid directly with the state. Be alert for scams. For example, it is not possible to “pre-qualify” for Medicaid, nor do you have to pay to apply.\

Learn more about changing from a Marketplace plan to Medicaid.

Yes. You may qualify for subsidized health coverage offered on HealthCare.gov. Contact a North Carolina health insurance navigator for enrollment assistance. Community health centers also provide low-cost care through a sliding scale based on your income and insurance status.