Medicaid Expansion in North Carolina – What You Need to Know

Medicaid Expansion finally took effect statewide on December 1st, 2023, thanks to over a decade of advocacy by countless organizations and individuals. All of us here at NCOHC and the Foundation for Health Leadership & Innovation (FHLI) are thrilled to see this important step forward for North Carolina take effect, but we will also continue working hard to improve health access and equity for all North Carolinians.

Medicaid Expansion is expected to provide over 600,000 people in the health care coverage gap, including veterans, frontline workers, small business owners, parents, and many more, with access to health insurance. This includes residents with incomes too high to qualify for Medicaid but too low to receive health care subsidies through the Affordable Care Act marketplace.

This insurance will include comprehensive health coverage, including dental, behavioral health, and vision care.

Find out whether you may be eligible for benefits and what Medicaid Expansion means for rural and other underserved communities across our state.

FAQs About Medicaid Expansion in North Carolina

Here are answers to some frequently asked questions about Medicaid Expansion in North Carolina effective December 1st, 2023:

Who is eligible for Medicaid Expansion in NC?

Most adults ages 19-64 who earn up to 138% of the federal poverty line (e.g., singles earning about $20,000/year or families of three earning about $34,000/year) may be eligible. Read more about eligibility requirements.

How can I apply for Medicaid in North Carolina?

Applying online through ePASS is the quickest option. For a step-by-step tutorial, watch this how-to YouTube video from the NC Department of Health and Human Services (NCDHHS). You can also apply in person, by phone, or by mail.

How long will it take for my Medicaid application to be processed?

It may take up to 45 days (about 1 and a half months) for your application to be processed. Apply today to access your benefits as soon as possible.

What does Medicaid health coverage include?

Medicaid includes primary care, hospital stays, maternity care, vision and hearing, dental/oral health care, and more.

What does Medicaid pay for?

Full Medicaid health care coverage pays for your doctor visits, yearly check-ups, emergency care, mental health, and more. There are no monthly fees and copays are never more than $4.

What Medicaid Expansion Means for Rural & Underserved Communities in NC

The 2023 North Carolina Rural Health Snapshot [PDF] report compiled by the North Carolina Rural Health Association (NCRHA), an FHLI program, shows that rural residents are 40% more likely to be uninsured and eligible for Medicaid Expansion.

It is expected to create an estimated 37,200 jobs, generate thousands in savings for small businesses, and bring billions of dollars in federal funding back to North Carolina annually. In addition to strengthening our economy, it will help our communities become more resilient and increase access to timely, affordable health care.

According to the NCRHA’s sweeping analysis, previous studies also show that Medicaid Expansion is associated with improved hospital financial performance and fewer hospital closures. Since 2010, when Medicaid Expansion first became an option for every state, seven rural hospitals have closed in North Carolina. We need to rebuild and expand the rural health infrastructure to effectively serve our rural and other historically underserved communities.

As hundreds of thousands of people gain access to coverage through Medicaid Expansion, we must continue to work at every level to create a more accessible and equitable health care system. This means expanding the number of culturally competent providers who accept Medicaid insurance for all types of care, including oral health and specialty services.

Stay Tuned for More on Medicaid Expansion in North Carolina

FHLI and all our programs will continue to advocate for all North Carolinians and leverage policies that increase health care access and equity across our state. While Medicaid Expansion is an important win expanding access to care across our state, much work will still need to be done to ensure those who gain coverage have access points to receive quality care.

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