How to apply for NC Medicaid

Last verified: June 2026

Four ways to apply for NC Medicaid

NCDHHS accepts applications through four channels. All paths lead to the same eligibility determination — your county Department of Social Services (DSS) makes the final decision regardless of how you apply.

Documents you'll need

Not every applicant needs every document. The list below covers what NCDHHS commonly requests during eligibility review. Having these ready before you start the ePASS application cuts back on follow-up requests.

• Proof of identity — driver's license, state ID, passport, or birth certificate
• Proof of North Carolina residency — utility bill, lease, or official mail with your current address
• Social Security number for each household member applying
• Proof of income — pay stubs (last 30 days), employer letter, or self-employment records
• Proof of citizenship or immigration status
• Health insurance information if you currently have other coverage
• Tax filing information if applying based on ACA expansion eligibility

Processing times and coverage start date

Under 42 CFR § 435.912, states must process most Medicaid applications within 45 calendar days. Applications based on disability — which require additional review — get up to 90 days. If your county DSS does not act within these timeframes, you have a right to appeal.

If approved, coverage in North Carolina generally starts on the first day of the month in which you applied. That means a complete application submitted on March 15 typically produces coverage retroactive to March 1.

Choosing a health plan after approval

After NC Medicaid approves your application, you'll need to choose a managed care health plan if you're enrolled in Standard or Tailored Plan coverage. NC's enrollment broker — reachable at ncmedicaidplans.gov or by calling 1-833-870-5500 — can explain the difference between the four Standard Plans and help you pick one based on your doctors, pharmacy, and location.

If you don't choose a plan within the enrollment period, NCDHHS assigns you to one automatically. You can switch plans later during the open enrollment window or in certain circumstances (moving, change in health needs).

Need help with your application?

The NC Medicaid Ombudsman provides free, independent assistance to applicants and enrollees. If you're having trouble with your application, a denial, or a coverage dispute, call the Ombudsman at 1-877-201-3750. The Ombudsman can't change eligibility decisions, but can help you understand your options and navigate the appeals process.

What to expect after you submit

Under 42 CFR § 435.912, NC Medicaid must process most applications within 45 days. Disability-based applications get 90 days. Coverage, if approved, starts on the first day of the month you applied.

1. 1

   Application date recorded

   Your county DSS records the submission date — this determines your potential coverage start date. Online applications via ePASS are time-stamped at submission.

2. 2

   Electronic verification

   NCDHHS checks income and identity through SSA, IRS, and NC state data. If verification succeeds, no additional documents are needed from you.

3. 3

   Document request (if needed)

   If verification fails, your county DSS contacts you to provide documentation. Check your ePASS account and the mailing address on file regularly during processing.

4. 4

   Eligibility decision

   Your county DSS issues a written approval or denial. If denied, the notice explains the reason and your right to request a fair hearing through the NC Office of Administrative Hearings.

5. 5

   Choose a Standard Plan or Tailored Plan

   If enrolled in Standard Plan coverage, compare the four plans at ncmedicaidplans.gov or call 1-833-870-5500. If you do not choose, NCDHHS auto-assigns you to a plan. Tailored Plan enrollees (BH/I/DD/TBI) are assigned to the regional Tailored Plan.