Medicaid in North Carolina: what you may be able to apply for
What it is
Public health insurance for low-income people, jointly funded by the federal and state governments. It covers doctor visits, hospital care, prescriptions, pregnancy, and children's care. States run it under federal rules, and each state has its own name and details (California calls it Medi-Cal).
NC Medicaid
Final eligibility is decided by the agency
Policies can change — always check the latest official information.
🔎 Will this affect your green card?
Regular Medicaid does NOT count in the public charge test — receiving it does not affect your green card or immigration application. First, a sentence that may make this whole section irrelevant to you: many people are outside this assessment altogether. The exemption categories Congress created by statute remain in force — DHS said so in the July 20, 2026 rule: what it removed was the list, while "USCIS will provide training and guidance to its officers, including information about which aliens are statutorily exempt from the public charge ground of inadmissibility". ✅ Each of the following rests on its own statute and does not disappear with that list: refugees (8 U.S.C. §1157(c)(3): paragraph (4) of §1182(a) "shall not be applicable"); refugees and asylees adjusting status (§1159(c), same wording); Special Immigrant Juveniles (§1255(h)(2)(A): paragraph (4) "shall not apply"); and VAWA self-petitioners, U nonimmigrant applicants or holders, and battered spouses and children under §1641(c) (§1182(a)(4)(E): "shall not apply"). Battered spouses and children have a second layer of statutory protection: the law forbids considering any public benefits for them (INA §212(s)). If you hold a T visa: the law allows immigration authorities to waive the public charge ground (§1255(l)(2), "may waive") — but that waiver is discretionary; it does not apply automatically as the categories above do. ✅ This does not mean you cannot get a waiver; it means it has to be requested and explained case by case. Have a lawyer help you prepare it. For the full list, and whether you are in it, have a lawyer check. ✅ For what you received before September 18, 2026, the rule considers only two things: (a) public cash assistance for income maintenance (SSI, TANF cash, and state, tribal, territorial or local general-assistance cash) and (b) long-term institutionalization at government expense. Anything outside those two is not counted — that is written into the rule itself and has not changed. But if you did receive (a) or (b) before that date, those are considered; have an attorney look at your specific situation. (This is in the rule itself: it applies only going forward — DHS "will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date".) And if this assessment does apply to you — from September 18, 2026 onwards, things change — means-tested public benefits received on or after that day - that is, the public benefits that look at your income or assets when you apply - and for example SNAP, Medicaid, CHIP and WIC, but not limited to these, because the rule names a whole category rather than a list, and not limited to federal programs either - state, territorial, Tribal and local ones count too (verbatim: "Federal, State, territorial, Tribal, and local programs that provide means-tested public benefits"); if you are not sure whether the one you receive counts, ask a licensed immigration attorney - may be weighed as one of the factors (the rule "will consider the receipt of any means tested public benefits on or after that date"). ✅ It is one factor among many, not an automatic denial. The rule requires each case to be weighed on all of its circumstances. How much weight any one of them carries has not been published — USCIS has not issued its operating guidance. We have not verified it; that is not the same as saying it has changed. If you are applying for a visa abroad, or entering at a port of entry: the above describes USCIS (applications filed inside the United States). The rule itself notes that CBP at a port of entry may consider different information; how consulates abroad apply it, we have not verified. See details →
Who may qualify
Income limit
- Adults 19-64 (ACA expansion)≤ 138% FPLNorth Carolina's official current income page lists the monthly income cap for adults 19-64 by family size: 1 $1,835; 2 $2,399; 3 $3,141; 4 $3,795; 5 $4,449 (marked "current until April 1, 2026," updated each April). This is the ACA-expansion adult group effective December 1, 2023, at about 138% FPL.
Source:NC Medicaid, North Carolina Department of Health and Human Services (medicaid.ncdhhs.gov) · checked 2026-07-21
Official excerpt
“Adult ages 19-64 — family of 1 $1,835/month or less; 2 $2,399; 3 $3,141; 4 $3,795; 5 $4,449. All dollar amounts are before taxes. Numbers are current until April 1, 2026.”
NC Medicaid Eligibility | NC Medicaid
View the official document → (Opens in a new tab)Calculated from the official sources listed below; not read as a single value from one quotation
- Children 0-18≤ 211% FPLNorth Carolina's official current income page lists the monthly income cap for children 0-18: 1 $2,807; 2 $3,806; 3 $4,804; 4 $5,803; 5 $6,802 (about 211% FPL). This tier is the continuous ceiling after Medicaid and NC Health Choice (North Carolina's CHIP) were combined — a North Carolina child is covered from the lowest incomes up to about 211% FPL (see this site's CHIP/NC Health Choice note).
Source:NC Medicaid, North Carolina Department of Health and Human Services (medicaid.ncdhhs.gov) · checked 2026-07-21
Official excerpt
“Child ages 0-18 — family of 1 $2,807/month or less; 2 $3,806; 3 $4,804; 4 $5,803; 5 $6,802. Numbers are current until April 1, 2026.”
NC Medicaid Eligibility | NC Medicaid
View the official document → (Opens in a new tab)Calculated from the official sources listed below; not read as a single value from one quotation
- Pregnancy≤ 196% FPLNorth Carolina's official current income page lists the monthly income cap for pregnant people: 1 $3,535; 2 $4,463; 3 $5,390; 4 $6,318; 5 $7,246 (about 196% FPL; count the unborn child in household size). Coverage continues for 12 months postpartum. North Carolina waives the five-year bar for lawfully residing pregnant people under CHIPRA Section 214 / ICHIA (see the immigration-status section). Note: North Carolina covers pregnancy through Medicaid, not through CHIP.
Source:NC Medicaid, North Carolina Department of Health and Human Services (medicaid.ncdhhs.gov) · checked 2026-07-21
Official excerpt
“Pregnant person — family of 1 $3,535/month or less; 2 $4,463; 3 $5,390; 4 $6,318; 5 $7,246. Numbers are current until April 1, 2026.”
NC Medicaid Eligibility | NC Medicaid
View the official document → (Opens in a new tab)Calculated from the official sources listed below; not read as a single value from one quotation
- NC Medicaid Eligibility | NC Medicaid (Opens in a new tab)
- Medicaid, CHIP, & BHP Eligibility Levels — official CMS MAGI table, state decisions as of Dec. 1, 2023; includes NC pregnancy 196%, VA pregnancy Medicaid/CHIP 143%/200%, IN CHIP/pregnancy 250%/208%, CO pregnancy CHIP 260%, MN pregnancy 278%, AL CHIP 312%, OK adults/children/pregnancy 133%/205%/205%, and ME children 300% (Opens in a new tab)
- Aged/Blind/Disabled (65+/ABD, non-MAGI)North Carolina's official current income page splits ages 65+ into two tiers: full Medicaid = 1 $1,330; 2 $1,804; and other programs (such as Medicare Savings Programs that help pay Medicare premiums) = 1 $1,796; 2 $2,435 (marked "current until April 1, 2026"). Aged/Blind/Disabled (ABD) runs through the non-MAGI pathway, which usually also has a resource/asset limit in addition to income (the official income page does not list that asset figure) — verify your specific tier and asset limit with your county DSS.
Source:NC Medicaid, North Carolina Department of Health and Human Services (medicaid.ncdhhs.gov) · checked 2026-07-21
Official excerpt
“Adult ages 65+ — family of 1 $1,330/month (full Medicaid) or $1,796/month (other programs); family of 2 $1,804 (full Medicaid) or $2,435 (other programs). Numbers are current until April 1, 2026.”
NC Medicaid Eligibility | NC Medicaid
View the official document → (Opens in a new tab)
Immigration-status rules in this state
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. 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. Read the scope of that official reassurance along with it: it is what North Carolina Medicaid's official page stated on its official page as of 2026-07-21. The federal public charge rule changes on September 18, 2026 — benefits you received before that date are judged under the current rule; we have not yet verified the rule that applies afterwards. If you are still unsure after that change, rely on the agency's latest statement and consult a licensed immigration attorney about your own case.Public charge: the federal conclusion — including what changes from September 18, 2026, the statutory exemptions, and how it differs abroad and at a port of entry — is set out in this program's program-level section and is not repeated here; repeating it would create a second source of truth.
How to apply
What you'll need
Proof of identity, income, North Carolina residency, household size, and Social Security number (if you have one); immigration/citizenship documents as applicable to the category. You can apply online (ePASS, epass.nc.gov), by phone, on paper, or in person at your County Department of Social Services (DSS), and also through HealthCare.gov. Applying only for emergency services (Emergency Medicaid) does not require immigration documentation. Applying for your children does not require the parents to have immigration status. See the official apply page for the exact document list.
Timeline
Eligibility decisions are generally made within 45 days (up to 90 days for disability-based cases); retroactive coverage for up to 3 months before the application month. Emergency Medicaid is handled on an emergency basis.
Go to the official application → (Opens in a new tab)ePASS (North Carolina's official online application, epass.nc.gov) · or visit your County Department of Social Services (DSS) · official info at medicaid.ncdhhs.gov
Will it affect your green card? (Public charge)
✅ Regular Medicaid does NOT count in the public charge test — receiving it does not affect your green card or immigration application. First, a sentence that may make this whole section irrelevant to you: many people are outside this assessment altogether. The exemption categories Congress created by statute remain in force — DHS said so in the July 20, 2026 rule: what it removed was the list, while "USCIS will provide training and guidance to its officers, including information about which aliens are statutorily exempt from the public charge ground of inadmissibility". ✅ Each of the following rests on its own statute and does not disappear with that list: refugees (8 U.S.C. §1157(c)(3): paragraph (4) of §1182(a) "shall not be applicable"); refugees and asylees adjusting status (§1159(c), same wording); Special Immigrant Juveniles (§1255(h)(2)(A): paragraph (4) "shall not apply"); and VAWA self-petitioners, U nonimmigrant applicants or holders, and battered spouses and children under §1641(c) (§1182(a)(4)(E): "shall not apply"). Battered spouses and children have a second layer of statutory protection: the law forbids considering any public benefits for them (INA §212(s)). If you hold a T visa: the law allows immigration authorities to waive the public charge ground (§1255(l)(2), "may waive") — but that waiver is discretionary; it does not apply automatically as the categories above do. ✅ This does not mean you cannot get a waiver; it means it has to be requested and explained case by case. Have a lawyer help you prepare it. For the full list, and whether you are in it, have a lawyer check. ✅ For what you received before September 18, 2026, the rule considers only two things: (a) public cash assistance for income maintenance (SSI, TANF cash, and state, tribal, territorial or local general-assistance cash) and (b) long-term institutionalization at government expense. Anything outside those two is not counted — that is written into the rule itself and has not changed. But if you did receive (a) or (b) before that date, those are considered; have an attorney look at your specific situation. (This is in the rule itself: it applies only going forward — DHS "will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date".) And if this assessment does apply to you — from September 18, 2026 onwards, things change — means-tested public benefits received on or after that day - that is, the public benefits that look at your income or assets when you apply - and for example SNAP, Medicaid, CHIP and WIC, but not limited to these, because the rule names a whole category rather than a list, and not limited to federal programs either - state, territorial, Tribal and local ones count too (verbatim: "Federal, State, territorial, Tribal, and local programs that provide means-tested public benefits"); if you are not sure whether the one you receive counts, ask a licensed immigration attorney - may be weighed as one of the factors (the rule "will consider the receipt of any means tested public benefits on or after that date"). ✅ It is one factor among many, not an automatic denial. The rule requires each case to be weighed on all of its circumstances. How much weight any one of them carries has not been published — USCIS has not issued its operating guidance. We have not verified it; that is not the same as saying it has changed. If you are applying for a visa abroad, or entering at a port of entry: the above describes USCIS (applications filed inside the United States). The rule itself notes that CBP at a port of entry may consider different information; how consulates abroad apply it, we have not verified.
⚠️ The one exception: Medicaid that pays for long-term institutional care (a long-term stay in a nursing facility or mental-health institution at government expense) DOES count. Everyday doctor visits, hospital care, prescriptions, and home- and community-based care are not this exception.
➕ Because the current rule excludes all non-institutional Medicaid, Medicaid for children, pregnancy, and emergencies also does not count. In mixed-status families, eligible citizen or qualified children can safely get the care they qualify for.
The statute itself names the moments at which this is assessed. INA § 212(a)(4)(A) (8 U.S.C. § 1182(a)(4)(A)) reads that an alien is inadmissible who, "in the opinion of the consular officer at the time of application for a visa, or in the opinion of the Attorney General at the time of application for admission or adjustment of status, is likely at any time to become a public charge." ⇒ Three occasions are named: applying for a visa, applying for admission, and applying for adjustment of status. Two things are commonly read too narrowly, and both errors point the same way — toward "this does not concern me": the statute says "a visa" and does not limit that to immigrant visas; and "application for admission" is its own separate occasion. We do not tell you whether your own situation is one of these — that depends on your case; consult a licensed immigration attorney.
The exemptions are not "a few categories" — the regulation lists twenty-nine of them. 8 CFR 212.23(a) opens: "The public charge ground of inadmissibility under section 212(a)(4) of the Act does not apply … to the following categories of aliens," and then runs (1) through (29). Among those most relevant to readers of this site: refugees (1); asylees (2); Cuban and Haitian entrants (5); Cuban Adjustment Act applicants (6); NACARA (7); Special Immigrant Juveniles (10); Temporary Protected Status (12); T nonimmigrants (17) and (18); U nonimmigrants (19); VAWA self-petitioners (20); battered spouses and children who are qualified aliens under PRWORA § 431(c) (21); Afghan and Iraqi interpreters (4); nationals of Vietnam, Cambodia and Laos (25). Category (29) has to be read along with the rest, and it is the one most easily missed: "Any other categories of aliens exempt under any other law from the public charge ground of inadmissibility provisions under section 212(a)(4) of the Act." ⇒ "I am not in the categories listed above" does not mean "I am not exempt." The full list of 29 is at 8 CFR 212.23(a). That regulation is scheduled for removal on September 18, 2026 (91 FR 45477); on that date this whole block closes rather than continuing to show old text — but the statutory exemptions themselves come from their own laws and do not disappear with it. Whether your case falls within one is a question for a licensed immigration attorney. These exemptions do not disappear with that list: in the rescission rule of July 20, 2026 DHS says so itself — "Although DHS is removing the regulation listing exemptions, the statutory exemptions created by Congress for certain Cuban and Haitian applicants for adjustment of status continue to exist." Note the scope of that sentence: it is DHS responding to a comment about Cuban and Haitian applicants, and it covers only those two groups. Each of the 29 categories rests on its own statute, which the regulation merely collected in one place - and that is why the list does not vanish with the regulation.
Renewing a green card and naturalizing are generally not occasions for a public charge assessment. For a green-card holder returning from a trip abroad, the statute writes out an exhaustive list of when they are treated as seeking admission at all. 8 U.S.C. § 1101(a)(13)(C): a lawful permanent resident "shall not be regarded as seeking an admission … unless the alien—" falls within one of six situations: (i) has abandoned or relinquished that status; (ii) has been absent for a continuous period in excess of 180 days; (iii) has engaged in illegal activity after departing; (iv) departed while under legal process seeking removal, including removal or extradition proceedings; (v) has committed an offense identified in 8 U.S.C. § 1182(a)(2), unless relief has since been granted under § 1182(h) or § 1229b(a); or (vi) is attempting to enter at a time or place other than as designated by immigration officers, or has not been admitted after inspection and authorization by an immigration officer. Those six are the whole of what the statute gives — the widely quoted "180 days" is only item (ii), not the only one. Whether your own situation falls within any of them is a question for a licensed immigration attorney; this site does not judge individual cases.
This is information only, not immigration, legal, or tax advice. Public charge and your personal status are complex — consult a licensed immigration attorney. We never tell you whether you "will" or "won't" be affected.
USCIS Policy Manual, Volume 8, Part G, Chapter 7 (benefits considered) and Chapter 3 (who it applies to) — 8 USCIS-PM G.7 / G.3; regulation 8 CFR 212.21–212.23; 2022 final rule 87 FR 55472. · 2022-12-23
Source:U.S. Citizenship and Immigration Services (uscis.gov) · checked 2026-07-16
Official excerpt
“Long-term institutionalization at government expense is the only category of Medicaid-funded services (limited to institutional services provided under section 1905(a) of the Social Security Act) considered in a public charge inadmissibility determination.”
Chapter 7 - Consideration of Current and/or Past Receipt of Public Cash Assistance for Income Maintenance or Long-term Institutionalization at Government Expense | USCIS · 8 USCIS-PM G.7
View the official document → (Opens in a new tab)Frequently asked questions
What is Medicaid?
Public health insurance for low-income people, jointly funded by the federal and state governments. It covers doctor visits, hospital care, prescriptions, pregnancy, and children's care. States run it under federal rules, and each state has its own name and details (California calls it Medi-Cal).
Who can apply for Medicaid in North Carolina?
Generally, Adults 19-64 (ACA expansion): ≤ 138% FPL; Children 0-18: ≤ 211% FPL; Pregnancy: ≤ 196% FPL. The agency makes the final determination.
Can non-citizens or people without immigration status get Medicaid?
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. 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. Read the scope of that official reassurance along with it: it is what North Carolina Medicaid's official page stated on its official page as of 2026-07-21. The federal public charge rule changes on September 18, 2026 — benefits you received before that date are judged under the current rule; we have not yet verified the rule that applies afterwards. If you are still unsure after that change, rely on the agency's latest statement and consult a licensed immigration attorney about your own case.Public charge: the federal conclusion — including what changes from September 18, 2026, the statutory exemptions, and how it differs abroad and at a port of entry — is set out in this program's program-level section and is not repeated here; repeating it would create a second source of truth. Federal Medicaid generally requires a "qualified" immigration status, and most people must wait five years after getting that status (the "five-year bar") before applying. Refugees, asylees, and certain others are exempt from the five-year wait; emergency Medicaid is available regardless of status. Some states (such as California) use state funds to cover more people — see your state's details. The 2025 federal law OBBBA (H.R.1, Public Law 119-21, enacted July 4, 2025) significantly narrows eligibility: effective Oct 1, 2026 (Section 71109), federal Medicaid/CHIP funding is limited to four groups — U.S. citizens/nationals, lawful permanent residents (LPRs), Cuban/Haitian entrants, and COFA migrants (Micronesia/Marshall Islands/Palau). Refugees, asylees, trafficking victims, parolees, and other "qualified aliens" who are not yet LPRs lose federal eligibility (refugees/asylees can generally regain it after becoming LPRs). Emergency Medicaid remains available regardless of status (though Section 71110 lowers its federal match to the regular FMAP effective Oct 1, 2026 — this does not change its availability); the state options for lawfully-residing children and pregnant women are preserved. Section 71119 adds community-engagement (work) requirements for ACA-expansion adults (19-64) effective Dec 31, 2026 (or sooner at state option) — at least 80 hours/month, with exemptions for pregnant/postpartum people, the medically frail, caretakers of a child under 14, and others. This is a changing area — check the latest official guidance. The agency makes the final determination.
Does getting Medicaid affect my green card?
Regular Medicaid does NOT count in the public charge test — receiving it does not affect your green card or immigration application. First, a sentence that may make this whole section irrelevant to you: many people are outside this assessment altogether. The exemption categories Congress created by statute remain in force — DHS said so in the July 20, 2026 rule: what it removed was the list, while "USCIS will provide training and guidance to its officers, including information about which aliens are statutorily exempt from the public charge ground of inadmissibility". ✅ Each of the following rests on its own statute and does not disappear with that list: refugees (8 U.S.C. §1157(c)(3): paragraph (4) of §1182(a) "shall not be applicable"); refugees and asylees adjusting status (§1159(c), same wording); Special Immigrant Juveniles (§1255(h)(2)(A): paragraph (4) "shall not apply"); and VAWA self-petitioners, U nonimmigrant applicants or holders, and battered spouses and children under §1641(c) (§1182(a)(4)(E): "shall not apply"). Battered spouses and children have a second layer of statutory protection: the law forbids considering any public benefits for them (INA §212(s)). If you hold a T visa: the law allows immigration authorities to waive the public charge ground (§1255(l)(2), "may waive") — but that waiver is discretionary; it does not apply automatically as the categories above do. ✅ This does not mean you cannot get a waiver; it means it has to be requested and explained case by case. Have a lawyer help you prepare it. For the full list, and whether you are in it, have a lawyer check. ✅ For what you received before September 18, 2026, the rule considers only two things: (a) public cash assistance for income maintenance (SSI, TANF cash, and state, tribal, territorial or local general-assistance cash) and (b) long-term institutionalization at government expense. Anything outside those two is not counted — that is written into the rule itself and has not changed. But if you did receive (a) or (b) before that date, those are considered; have an attorney look at your specific situation. (This is in the rule itself: it applies only going forward — DHS "will only consider the receipt of public cash assistance for income maintenance and long-term institutionalization at government expense before the effective date".) And if this assessment does apply to you — from September 18, 2026 onwards, things change — means-tested public benefits received on or after that day - that is, the public benefits that look at your income or assets when you apply - and for example SNAP, Medicaid, CHIP and WIC, but not limited to these, because the rule names a whole category rather than a list, and not limited to federal programs either - state, territorial, Tribal and local ones count too (verbatim: "Federal, State, territorial, Tribal, and local programs that provide means-tested public benefits"); if you are not sure whether the one you receive counts, ask a licensed immigration attorney - may be weighed as one of the factors (the rule "will consider the receipt of any means tested public benefits on or after that date"). ✅ It is one factor among many, not an automatic denial. The rule requires each case to be weighed on all of its circumstances. How much weight any one of them carries has not been published — USCIS has not issued its operating guidance. We have not verified it; that is not the same as saying it has changed. If you are applying for a visa abroad, or entering at a port of entry: the above describes USCIS (applications filed inside the United States). The rule itself notes that CBP at a port of entry may consider different information; how consulates abroad apply it, we have not verified. The one exception: Medicaid that pays for long-term institutional care (a long-term stay in a nursing facility or mental-health institution at government expense) DOES count. Everyday doctor visits, hospital care, prescriptions, and home- and community-based care are not this exception. The exemptions are not "a few categories" — the regulation lists twenty-nine of them. 8 CFR 212.23(a) opens: "The public charge ground of inadmissibility under section 212(a)(4) of the Act does not apply … to the following categories of aliens," and then runs (1) through (29). Among those most relevant to readers of this site: refugees (1); asylees (2); Cuban and Haitian entrants (5); Cuban Adjustment Act applicants (6); NACARA (7); Special Immigrant Juveniles (10); Temporary Protected Status (12); T nonimmigrants (17) and (18); U nonimmigrants (19); VAWA self-petitioners (20); battered spouses and children who are qualified aliens under PRWORA § 431(c) (21); Afghan and Iraqi interpreters (4); nationals of Vietnam, Cambodia and Laos (25). Category (29) has to be read along with the rest, and it is the one most easily missed: "Any other categories of aliens exempt under any other law from the public charge ground of inadmissibility provisions under section 212(a)(4) of the Act." ⇒ "I am not in the categories listed above" does not mean "I am not exempt." The full list of 29 is at 8 CFR 212.23(a). That regulation is scheduled for removal on September 18, 2026 (91 FR 45477); on that date this whole block closes rather than continuing to show old text — but the statutory exemptions themselves come from their own laws and do not disappear with it. Whether your case falls within one is a question for a licensed immigration attorney. These exemptions do not disappear with that list: in the rescission rule of July 20, 2026 DHS says so itself — "Although DHS is removing the regulation listing exemptions, the statutory exemptions created by Congress for certain Cuban and Haitian applicants for adjustment of status continue to exist." Note the scope of that sentence: it is DHS responding to a comment about Cuban and Haitian applicants, and it covers only those two groups. Each of the 29 categories rests on its own statute, which the regulation merely collected in one place - and that is why the list does not vanish with the regulation. This is information only, not immigration, legal, or tax advice. Public charge and your personal status are complex — consult a licensed immigration attorney. We never tell you whether you "will" or "won't" be affected.
How do I apply for Medicaid in North Carolina?
Proof of identity, income, North Carolina residency, household size, and Social Security number (if you have one); immigration/citizenship documents as applicable to the category. You can apply online (ePASS, epass.nc.gov), by phone, on paper, or in person at your County Department of Social Services (DSS), and also through HealthCare.gov. Applying only for emergency services (Emergency Medicaid) does not require immigration documentation. Applying for your children does not require the parents to have immigration status. See the official apply page for the exact document list. Eligibility decisions are generally made within 45 days (up to 90 days for disability-based cases); retroactive coverage for up to 3 months before the application month. Emergency Medicaid is handled on an emergency basis. Policies can change — always check the latest official information. https://epass.nc.gov
Official sources
- Medicaid, CHIP, & BHP Eligibility Levels — official CMS MAGI table, state decisions as of Dec. 1, 2023; includes NC pregnancy 196%, VA pregnancy Medicaid/CHIP 143%/200%, IN CHIP/pregnancy 250%/208%, CO pregnancy CHIP 260%, MN pregnancy 278%, AL CHIP 312%, OK adults/children/pregnancy 133%/205%/205%, and ME children 300% (Opens in a new tab)
Centers for Medicare & Medicaid Services (Medicaid.gov) · checked 2026-08-22 · Document effective 2023-12-01
- NC Medicaid Eligibility | NC Medicaid (Opens in a new tab)
NC Medicaid, North Carolina Department of Health and Human Services (medicaid.ncdhhs.gov) · checked 2026-08-22 · This document states no effective date
- Poverty Guidelines | ASPE (Opens in a new tab)
U.S. Department of Health and Human Services, ASPE (aspe.hhs.gov) · checked 2026-08-22 · Document effective 2026-01-13
- Immigration Status and Eligibility for NC Medicaid | NC Medicaid (Opens in a new tab)
NC Medicaid, North Carolina Department of Health and Human Services (medicaid.ncdhhs.gov) · checked 2026-08-22 · This document states no effective date
- NC Medicaid Expansion Questions and Answers — North Carolina adopted the ACA Medicaid expansion, which launched December 1, 2023, covering income-eligible adults ages 19-64 up to 138% FPL (Opens in a new tab)
NC Medicaid, North Carolina Department of Health and Human Services (medicaid.ncdhhs.gov) · checked 2026-07-21 · Document effective 2023-12-01
Last checked: 2026-07-21
Policies can change — always check the latest official information.
This site is informational only and is not immigration, legal, or tax advice. For public charge and your personal status questions, consult a licensed immigration attorney.