How to get Medicaid or low-cost care in North Carolina

Medicaid reached more people in North Carolina in 2023

NC Medicaid is run by the state Department of Health and Human Services. The state says NC Medicaid expanded to more people in December 2023. If you were turned down before, it is worth checking again.

Adults under 65 can now qualify when household income is at or below 138 percent of the federal poverty level. That level is a yearly dollar amount the government uses to measure poverty, and it goes up with the number of people in your home. Our guide to the Medicaid coverage gap explains the problem that expansion was meant to fix.

Four ways to apply for NC Medicaid

The state lists four different ways to apply for coverage. The first is online with ePASS, the state's secure website, where you need an NCID to begin. An NCID is a state user login, and the site shows you how to make one. The second is a visit to your county Department of Social Services, which is the office that handles benefits in your county. The third is a paper form that you print and sign, and then mail or drop off there.

The fourth way is to call your county office and apply by phone. The NC Medicaid Contact Center at 888-245-0179 can help you find it. The center is open Monday through Friday, from 8 in the morning to 5 in the afternoon, and it is closed on state holidays.

A decision usually takes up to 45 days, or up to 90 days for a disability application. To see which papers to gather first, read our guide on how to apply for Medicaid. If you need help with a notice or a bill, the NC Medicaid Ombudsman gives free help at 1-877-201-3750.

New Medicaid rules that start in 2027

North Carolina lists several changes from the 2025 federal law. Two of them begin on January 1, 2027, for adults ages 19 to 64. One is a work requirement, and the other is renewals every six months instead of once a year.

Under the work rule, you must work, go to school or volunteer for 80 hours a month. Income of at least $580 a month also meets the rule. You must be able to show proof of your hours or income. The state lists exemptions, such as people with a disability, parents of children under 14 and pregnant people.

Retroactive coverage changes on that same date as well. This is coverage for medical bills from before your application date. Starting January 1, 2027, adults 19 to 64 without a disability get up to one month. People with a disability, children and adults 65 and older get up to two months. The state says that if you apply by December 31, 2026, you can get up to three months.

The state says you will receive a notice if you need to act. Keep your address current with your county office and open every letter from NC Medicaid. Write down the date on each letter and the deadline it gives you. A short note on your calendar can keep you from missing a due date.

When you earn more than the Medicaid limit

People who do not qualify for Medicaid can look for a plan on HealthCare.gov. Many people there get help paying the monthly cost, and the site shows your amount after you enter your income. Our guide on health insurance without a job explains how the sign-up window works.

Community health centers in North Carolina

The North Carolina Community Health Center Association is the state group for patient-governed health centers. It formed in 1978 and has 43 member organizations. The association says its member centers serve nearly half a million patients and offer sliding-fee services, which means the price depends on your income.

Its website has a Find a Health Center button. The federal Find a Health Center tool from the Health Resources and Services Administration works with a zip code. Our guide on free clinics near me explains how free clinics differ from health centers. When you call a center, ask what you should bring to a first visit. Also ask whether staff can answer questions about your Medicaid application, since some centers have people who help with this and others do not.

Looking up a North Carolina doctor

The North Carolina Medical Board has a public tool called Look up a doctor or PA. It is linked from the board's home page. A PA is a physician assistant, a health worker who treats patients with a doctor's oversight.

Our directory lets you search for cash-pay doctors by location. If a doctor offers a monthly fee, ask what it covers and read the agreement before you sign. Some cash-pay doctors post their visit prices online, and others will tell you the price when you call. Ask for that price before you book a visit.

If you have an emergency in North Carolina

In an emergency, call 911 or go to the nearest emergency room. A hospital with an emergency room has to examine you under federal law, whether or not you have Medicaid. If a bill arrives later, our guide on hospital financial assistance shows how to ask for help.