Medicaid Expansion begins on December 1: A Game-Changer for Poor and Working Class North Carolinians

Medicaid is a crucial health insurance program designed to provide assistance to poor and working-class families. This program helps cover a wide range of healthcare services, including doctor bills, hospital bills, prescriptions, vision care, dental care, nursing home care, mental health care, and more. It also helps with personal care services, medical equipment, and other home health services. Additionally, Medicaid covers most medically necessary services for children under 21.

Until now, nearly 600,000 North Carolinians were trapped in a dangerous situation where they couldn’t afford health insurance, but they earned too much to qualify for Medicaid. However, thanks to the persistent organizing of working people, beginning on December 1st, Medicaid has expanded its income threshold, now including individuals who make up to $20,120 for a single adult.

This expansion means that even if you were previously denied or lost Medicaid coverage since the pandemic ended, you may now qualify under the new criteria. If you are between the ages of 19 and 64 and your household income falls within the following chart, you may be eligible for Medicaid:

  • Single Adults: $20,120 or less
  • Family of 2: $27,214 or less
  • Family of 3: $34,307 or less
  • Family of 4: $41,400 or less
  • Family of 5: $48,493 or less
  • Family of 6: $55,586 or less

Applying for Medicaid is free, and assistance is available to help you with the application process at no cost.

Frequently Asked Questions about Medicaid

When does the Medicaid expansion start? Is there a deadline to apply?

The Medicaid expansion in North Carolina commenced on December 1st, and you can apply at any time afterward. There is no specific deadline to apply as enrollment is open year-round.

How can I apply for Medicaid?

There are various options available to apply for Medicaid:

  • Online: You can complete the application online, and it typically takes around an hour. Visit the Healthcare.gov website and follow the links for Medicaid enrollment. This application will take about an hour to complete.
  • Over the phone: You can apply by calling either of the following numbers:
    • NC Medicaid Contact Center: (888) 245-0179
    • NC Navigator Consortium: (855) 733-3711
  • Virtual assistance: You can schedule an appointment with the NC Navigators by phone or via Zoom for free, unbiased enrollment assistance.

What information do I need for the application?

To apply for Medicaid, you will need the following information:

  • Full legal names of all applicants
  • Dates of birth of all applicants
  • Social Security numbers (or immigration documents) for all applicants
  • Home and/or mailing address for everyone applying for coverage
  • Best estimate of your household income for the current year, including employment and income information for each member of your household (e.g., pay stubs, income verification letter from employer, or W-2 forms/tax returns)
  • Previous year’s Medicaid or Marketplace enrollment information and HealthCare.gov username and password (if applicable)
  • List of current doctors/providers and medications (if applicable)
  • Immigration documents, such as I-94 or a green card (if applicable)

Note that North Carolina verifies the information provided using external resources. If additional information is needed, you will receive a letter from your local DSS.

What about the Children’s Health Insurance Program (CHIP)?

North Carolina’s Children’s Health Insurance Program (CHIP) remains unchanged. Children up to the age of 19 may be eligible for CHIP, even if their parent or guardian does not qualify for Medicaid. CHIP offers low-cost health coverage to children in families whose income exceeds the Medicaid threshold. To learn whether your children qualify and to enroll them, call 1-877-KIDS-NOW (1-877-543-7669) for assistance.

Where can I find in-person assistance?

The NC Navigator Network organizes in-person enrollment events throughout the state. Visit their website to find an event near you (scroll to the bottom). These events do not require an appointment, so you can receive assistance at your convenience. You can also make an appointment at your local DSS office for in-person Medicaid enrollment assistance. 

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