Medicaid in North Carolina: what you may be able to apply for

🌟 North Carolina only recently adopted the ACA Medicaid expansion (effective December 1, 2023 — after being a non-expansion state for years, this is a recent major change), and now covers income-eligible adults 19-64 up to about 138% of the Federal Poverty Level. It is administered by the NC Department of Health and Human Services (NCDHHS); you apply through ePASS (epass.nc.gov) or your County Department of Social Services (DSS). North Carolina's official current income table (marked "current until April 1, 2026") lists monthly income by family size: Adult ages 19-64, family of 1 $1,835; Child ages 0-18, family of 1 $2,807; Pregnant person, family of 1 $3,535. On immigration status (safety-critical), the official NC Medicaid page states: "To get full health care coverage through Medicaid in North Carolina if you are not a U.S. citizen, you must: Live in North Carolina, Meet the regular rules for Medicaid like age and income, and Have a qualified immigration status or a special exception." Qualified immigrants generally face a five-year waiting period (e.g., green-card holders); 🌟 but North Carolina has elected the CHIPRA Section 214 / ICHIA ("lawfully residing") option: a child under 19 with any kind of lawful immigration status (except DACA), and a pregnant person with any kind of lawful status (except DACA), can apply for full NC Medicaid without the five-year wait; refugees, asylees, and people paroled for at least one year from Afghanistan, Ukraine, Cuba, or Haiti are also not subject to the five-year bar. For people without a qualifying status, North Carolina offers Emergency Medicaid, which the state says applies regardless of status and for which "No immigration documentation is required"; an undocumented pregnant person who meets the income and residency rules can be covered for emergency services including labor and delivery, but not full Medicaid. 🔴🔴 Safety-critical points: the state explicitly says "Undocumented parents or guardians can apply for their children to get Medicaid" and "You are not considered a 'public charge' if you apply for or have Medicaid." — undocumented parents can apply for their children, and applying for or receiving Medicaid is not a public charge and does not affect the parents' own status. 🔴 Did-not-find, stated honestly: unlike California or Illinois, we did not find any North Carolina state-funded program providing full-scope Medicaid to undocumented adults or children — for people without a qualifying status, North Carolina's Medicaid pathway is Emergency Medicaid only. Do not assume the whole family is barred, and do not assume everyone qualifies for full coverage — a mixed-status household can have some members on full Medicaid (e.g., citizen or lawfully residing children) and others eligible only for emergency services. 🔴 A federal law change is scheduled to narrow immigrant Medicaid/CHIP eligibility effective October 1, 2026; because immigration rules are safety-critical and changing, verify your own household with your county DSS or through ePASS.