North Carolina Medicaid Eligibility Requirements
This page provides general guidelines for the North Carolina Medicaid eligibility requirements. This is an assistance program that provides medical coverage for low-income people of all ages. The department that handles the Medicaid program is North Carolina Department of Health and Human Services. If you have questions or issues about the Medicaid application or the eligibility requirements, contact the North Carolina Medicaid office.
North Carolina Medicaid Overview
Medicaid is for eligible persons who need help paying their medical bills.
North Carolina Medicaid Eligibility Requirements - Non Income
Enrollees must be U.S. citizens or legal permanent residents and live in North Carolina. Non-citizens that would be Medicaid eligible on all factors other than their citizenship status may be eligible for Medicaid to cover medical emergencies, including the birth of a child. Before Medicaid may be authorized, applicants must provide proof from a medical professional stating the treatment was due to an emergency condition.
Documents Needed For North Carolina Medicaid Application
- Proof of income
- Social security number
- Proof of assets
- Proof of pregnancy if you are pregnant
North Carolina Medicaid Benefits
Regular Medicaid: Doctor visits, Hospital visits, Prescriptions, Dental, Vision, Medicare premiums, Nursing home care, In-home care, Mental health care, Most medically necessary services for children under age 21, Personal care services, Medical equipment, and other home health services.
Medicaid for Pregnant Women: Maternity services only. Prenatal care, delivery and 60 days postpartum care, treating medical conditions which may complicate the pregnancy (approval for some services needed), childbirth and parenting classes, family planning, Maternity Care Coordination services.
North Carolina Medicaid & CHIP Eligibility Levels
Below is the modified adjusted gross income (MAGI) eligibility levels for North Carolina Medicaid and Children's Health Insurance Program (CHIP).
Eligibility Levels - By Percentage Of Federal Poverty Level (FPL)
Medicaid Expansion | Medicaid Children | Separate CHIP | Pregnant Women | Parents | Other Adults | |||
---|---|---|---|---|---|---|---|---|
No |
|
211% (6-18) | Medicaid: 196% CHIP: N/A |
45% | 0% |
Eligibility Levels - Individual By Monthly Income
Medicaid Expansion | Medicaid Children | Separate CHIP | Pregnant Women | Parents | Other Adults | |||
---|---|---|---|---|---|---|---|---|
No |
|
$2,052 (6-18) | Medicaid: N/A CHIP: N/A |
$438 | $0 |
Eligibility Levels - Family Of Two By Monthly Income
Medicaid Expansion | Medicaid Children | Separate CHIP | Pregnant Women | Parents | Other Adults | |||
---|---|---|---|---|---|---|---|---|
No |
|
$2,766 (6-18) | Medicaid: $2,569 CHIP: N/A |
$590 | $0 |
Eligibility Levels - Family Of Three By Monthly Income
Medicaid Expansion | Medicaid Children | Separate CHIP | Pregnant Women | Parents | Other Adults | |||
---|---|---|---|---|---|---|---|---|
No |
|
$3,480 (6-18) | Medicaid: $3,232 CHIP: N/A |
$742 | $0 |
Eligibility Levels - Family Of Four By Monthly Income
Medicaid Expansion | Medicaid Children | Separate CHIP | Pregnant Women | Parents | Other Adults | |||
---|---|---|---|---|---|---|---|---|
No |
|
$4,194 (6-18) | Medicaid: $3,896 CHIP: N/A |
$894 | $0 |