Medicaid is a medical assistance program that serves children, adults and families.
For those who qualify, it includes doctor visits, check-ups, emergency care, hospital services, maternity and postpartum care, vision and hearing services, prescription drugs, behavioral health, preventive and wellness services, dental/oral health care, devices, and more. There is no monthly fee and copays are never more than $4.
More people in Wake County can now get health care through Medicaid!
Starting December 1, 2023, NC Medicaid will cover people ages 19 through 64 years with higher incomes. You may be able to get health care coverage even if you didn’t qualify before – at little or no cost to you!
Most people will be able to get coverage if you're a citizen (some non-US citizens can also qualify) and your household income falls within these amounts:
- Single Adults: $1,676/month or less ($20,120/year)
- Family of 2: $2,267/month or less ($27,214/year)
- Family of 3: $2,859/month or less ($34,307/year)
- Family of 4: $3,450/month or less ($41,400/year)
- Each additional person: add $591/month (add $7,094/year)
If someone is pregnant, they may be eligible for other NC Medicaid programs to get full health benefits.
Aprende sobre la expansión de Medicaid en español
Introduction to NC Medicaid Managed Care (English)
Introduction to NC Medicaid Managed Care (Spanish)
Learn about NC Medicaid Managed Care
Do you have Medicaid now and ready to enroll in a Medicaid Managed Care Plan?
NC Medicaid Ombudsman
The NC Medicaid Ombudsman is an advocate for beneficiaries to provide free, confidential assistance to educate and empower people with Medicaid during the change to Medicaid Managed Care. The Ombudsman also connects people to resources like social services, housing resources, food assistance, legal aid and other programs.
Learn more about Medicaid Programs
Family and Children’s Medicaid
- Covers children through age 20, parents and caretakers of minor children under the age of 18, and pregnant women who meet income requirements.
- Family Planning Program (FPP) is designed to reduce unintended pregnancies and improve the well-being of children and families. Services are provided to eligible persons of any age who are ineligible for all other Medicaid programs.
- North Carolina Health Choice (NCHC) Health Insurance for Children provides reduced price comprehensive coverage for children six to 18 years whose family income meets certain limits but is too high to qualify for Medicaid.
Adult Medicaid
- Provides coverage for disabled or blind persons of any age and adults aged 65 or older. There are income and reserve limits for these programs.
- Private Living Assistance (PLA) Medicaid covers individuals or couples living in their own homes or apartments, or in the homes of relatives or friends.
- Special Assistance coverage helps pay the cost of care for adults over the age of 18 living in an adult care home, rest home or other assisted living facility.
- Special Assistance-In Home offers monthly payments to help individuals at risk for adult care home placement to continue living at home.
- Long Term Care (LTC) Medicaid helps pay for care in a nursing home or intermediate care facility. Learn more about Long Term Care Medicaid.
Community Alternatives Program (CAP) and Program of All-inclusive Care for the Elderly (PACE)
- Community Alternatives Program (CAP) and Program of All-Inclusive Care for the Elderly (PACE) provide home and community-based services that allow Medicaid beneficiaries who require nursing home care to live safely at home
- Learn more about the Community Alternatives Program
- Learn more about PACE
Medicare-Aid for Qualified Beneficiaries (MQB)
- MQB is a limited assistance program for individuals enrolled in Medicare Part A and/or Medicare Part B.
- MQB helps pay for Medicare premiums and in some cases, Medicare coinsurance and deductibles.
- If found eligible for MQB, the process usually takes three to four months to receive coverage. Any premiums deducted from a Social Security check that the State is responsible for paying, will be reimbursed. If Medicaid stops for any reason, Medicaid will no longer pay the Medicare premium.
- To participate in MQB, individuals must apply for Medicaid first. There is not a separate application process for MQB.
Notice: To persons who have had or may in the future have their Medicaid benefits terminated or reduced in North Carolina
Franklin et al. v. Kinsley, formerly known as Hawkins et al. v. Cohen, is a federal lawsuit filed in 2017. This case was certified by the Court as a class action lawsuit on behalf of N.C. Medicaid beneficiaries.
Contact Us
Call: 919-212-7000
Fax: 919-212-7028
Mail:
Wake County Health & Human Services
P.O. Box 46833
Raleigh, NC 27620