North Carolina expands Medicaid coverage

While Medicaid coverage has historically been available to a limited number of underserved populations, the Affordable Care Act (ACA) gave states the option to expand coverage as of January 1, 2014. This option offers coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level. Currently, 41 states including Washington D.C. have adopted expansion of coverage.

Research shows that Medicaid expansion has numerous benefits including improvements in population health outcomes, reduction of premature deaths and increases in financial security and opportunities for economic mobility.² Research also shows that states which have adopted expansion see an increase in the number of patients discharged to rehabilitation facilities as well as a decrease in the hospital mortality rate for Black trauma youth patients following injuries.³

North Carolina is one of the most recent states to implement coverage expansion. As of December 1, 2023, North Carolinian U.S. citizens aged 19 to 64 within the specified income bracket will qualify for Medicaid. Household size and income requirements are as follows:

• Single adults making $20,120 or less
• Household size of 2 making $27,214 or less
• Household size of 3 making $34,307 or less
• Household size of 4 making $41,400 or less
• Household size of 5 making $48,493 or less
• Household size of 6 making $55,586 or less

Non-U.S. citizens living in North Carolina may be eligible if they have had the “qualified” immigration status for five years.

Individuals already enrolled in Medicaid’s limited Family Planning program who are eligible for the expansion will be automatically moved to full Medicaid expansion benefits. They will receive a new Medicaid insurance card and a letter from the state confirming their enrollment in full Medicaid benefits.

Medicaid services are provided at low or no cost to members and include (but are not limited to) primary care, inpatient/outpatient hospital services, maternity/postpartum care, behavioral health services and prescription drug benefits. Medicaid applications can be found on the ePASS website. For those who can’t apply online, additional options include telephone and in-person appointments at local Department of Social Services (DSS) offices as well as mail-in applications.

UnitedHealthcare Community Plan of North Carolina encourages members to reach out to their local DSS office to determine their eligibility status. Learn more about Medicaid expansion and its impact on North Carolina communities.