North Carolina Expanded Medicaid
North Carolina expanded Medicaid under the ACA in December 2023, making it one of the last states to do so. As of 2026, NC Medicaid (also called NC Medicaid Direct and NC Medicaid Managed Care) covers adults ages 19-64 who earn up to 138% of the Federal Poverty Level — approximately $21,597/year for a single adult.
Who Qualifies for NC Medicaid in 2026?
- Adults ages 19–64 with income at or below 138% FPL (~$21,597/year, single; ~$44,367/year, family of 4)
- Must be a U.S. citizen or qualifying immigrant
- Must be a North Carolina resident
- Cannot have access to affordable employer-sponsored coverage
How to Apply for NC Medicaid
Apply at epass.nc.gov or by calling the NC FAST line at 1-800-662-7030. You can also apply in person at your county Department of Social Services office. Coverage can begin as early as the first day of the month in which you apply if you are found eligible.
NC Medicaid Managed Care Plans
Most NC Medicaid enrollees receive care through managed care plans rather than fee-for-service Medicaid. The managed care plans operating in North Carolina include:
- Aetna Better Health of NC
- Carolina Complete Health (Centene)
- Healthy Blue NC (BCBS of NC)
- UnitedHealthcare Community Plan of NC
- WellCare of NC
Enrollees choose a plan at enrollment; if no choice is made, one is assigned. You can switch plans once per year.
NC Medicaid vs. Marketplace in North Carolina
If your income is below 138% FPL, NC Medicaid is almost always the better option: $0 premium, $0 deductible, minimal copays. If your income is above 138% FPL, marketplace plans with subsidies are available. An independent broker can help you understand exactly where your income puts you and which program provides the best value.