North Carolina Medicaid income limits 2025

Last verified: June 2026

Income limits by coverage group

NC Medicaid uses different income thresholds depending on who is applying. MAGI-based programs (most working-age adults, children, and pregnant women) use a modified adjusted gross income calculation aligned with federal tax rules. Non-MAGI programs — primarily for seniors and people with disabilities — use different financial rules and include an asset test.

Dollar figures below are based on 2025 Federal Poverty Level figures as published by NCDHHS. FPL amounts are adjusted each January — verify current thresholds at medicaid.ncdhhs.gov.

Family size and the 138% FPL threshold

Per NCDHHS figures, a single adult qualifies for expansion Medicaid at roughly $1,800 per month in gross income. A family of three qualifies at roughly $3,065 per month. These figures track the 2025 federal poverty guidelines and are adjusted each year. The income counted is gross household income — before taxes, before most deductions.

One counterintuitive fact: some types of income are excluded from MAGI calculations under IRS rules. Child support received, certain veterans' benefits, and workers' compensation are examples. If your gross pay looks too high but you receive income that may be excluded, don't assume you're ineligible before applying — ePASS will calculate your MAGI automatically.

No monthly premium — and a $4 copay cap

NC Medicaid charges no monthly premium for any enrollee group, including the newly expanded adults. Copays exist for some services but are capped at $4 per service. Emergency services and preventive care are typically copay-free.

NC Health Choice — the separate CHIP program for children ages 6–18 between 100% and 210% FPL — may charge small premiums and modest copays at higher income levels. Those children who fall below 100% FPL in that age range qualify for full NC Medicaid instead, with no cost sharing.

Asset rules — MAGI vs. non-MAGI programs

The ACA expansion, children's programs, and pregnancy coverage use MAGI rules, which means no asset test. Your savings, car, or home value do not count against you. This is different from older Medicaid programs for seniors and people with disabilities, which were built before MAGI existed and still apply resource limits.

For nursing facility Medicaid and long-term care programs, the asset limit is $2,000 for a single individual. A home (under certain conditions), one vehicle, and personal property are exempt from this count. Married couples are subject to spousal impoverishment protections under federal law, which allow the community spouse to retain a portion of the couple's assets — see the seniors and long-term care page for detail.

138% FPL income limit by household size (2025)

The table below shows the approximate monthly and annual gross income limits for adult NC Medicaid eligibility (138% FPL) based on 2025 HHS federal poverty guidelines as reported by NCDHHS.

Figures are approximate based on 2025 HHS federal poverty guidelines as reported by NCDHHS. Income counted is gross household income under MAGI rules. Verify current thresholds at medicaid.ncdhhs.gov or call 1-888-245-0179. ePASS calculates your MAGI automatically when you apply.

What counts as income for NC Medicaid (MAGI rules)

If your gross income looks too high but you receive income that may be excluded from MAGI, apply anyway — ePASS calculates your MAGI automatically and may find you eligible. Self-employment income is counted as net earnings after allowable business expenses.