Are You Now Eligible?
WNCCHS takes all plans and is accepting new patients!
Starting Dec. 1, 2023, NC Medicaid will cover more people in North Carolina. You may be eligible for health care coverage through Medicaid even if you didn’t qualify before – at little or no cost to you.
Learn everything you need below, or visit Medicaid.ncdhhs.gov.
Flyer: Get Ready for Medicaid Expansion
Who is Eligible?
Most people will be able to get health care coverage through Medicaid if they meet the criteria below. And if you were eligible before, you still are!
You live in North Carolina
You are a citizen. (Some non-US citizens can also get Medicaid health care coverage).
And if your household income fits within the chart below:
To determine whether you are eligible for Medicaid expansion, compare your household size to the 138% Federal Poverty Level for 2023.
How to Apply for Medicaid
Beginning December 1, 2023
WNCCHS patients, make sure WNCCHS is listed as your health care provider (or “PCP”) when applying!
NC Medicaid Covers Most Health Services, Including:
Primary care so you can go to a doctor for a check-up or when you don't feel well
Maternity and postpartum care if you are pregnant and after giving birth
Vision and hearing services
Prescription drug benefits to pay for medications
Dental and behavioral health services
Preventive and wellness services
Medical devices and other therapies
There is no monthly fee and copays are never more than $4.
WNCCHS Medicaid Patients Are Eligible for Even More!
Including referrals for food boxes, transportation + car repairs, home weathering & renovations, home goods, utility assistance, and legal assistance.
When enrolling Medicaid, you must enroll in a health plan. All plans are required to have the same type of Medicaid services you get now. These include:
Doctor visits | Medical supplies | Hospital visits | Lab tests and X-rays | Behavioral health care | Therapies | Prescriptions | Hospice | Eye care
WNCCHS accepts all Medicaid health plans.
To see the full list of NC Medicaid covered services provided by the health plans, go to ncmedicaidplans.gov. WNCCHS accepts all Medicaid health plans.
WNC Family Planning Program Update
NCDHHS has started contacting the approximately 260,000 people who are enrolled in Medicaid’s limited Family Planning program and who are eligible for full NC Medicaid benefits starting December 1, 2023.
Text messages, phone calls and emails will be sent starting today to let those eligible know to look out for a letter from their local Department of Social Services. The letter will look like this example, available on the NCDHHS website.
Not everyone with limited Family Planning Program benefits will be automatically enrolled in full coverage through NC Medicaid. Some people may have income that exceeds the new Medicaid eligibility levels, even though qualifying income levels are higher than the past.
Frequently Asked Questions
Once I am enrolled in Medicaid, can I still be a WNCCHS patient?
Yes, for as long as you choose to be! WNCCHS serves patients who are both uninsured and insured, which includes Medicaid. You can enroll in Medicaid and continue to see your WNCCHS provider per usual -- in fact, you become eligible for even more assistance/services!
Will I be impacted if I currently receive Medicaid?
Current beneficiaries with full Medicaid coverage will not see any changes.
Download NCDHHS's FAQ Document HERE
When and how do I apply for Medicaid?
You can apply beginning Dec. 1. The best way to apply is online through ePASS; you can also apply in-person, by phone or mailed applications. The processing time for applications can be up to 45 days. Applications submitted online may be processed faster.
What health plans are available for Medicaid?
Medicaid recently transitioned to a managed care model and most enrollees must choose the health plan that best works for them. Click here to view health plan options available for you. Many providers accept Medicaid plans, and WNCCHS accepts them all.
How much will it cost?
Health care visits will be either free or low cost. You will not have pay a monthly premium to enroll in Medicaid expansion.
Did you receieve a letter from NCDHHS that said your benefits were changing?
Some people who have limited benefits through the NC Family Planning Medicaid Program will automatically get full Medicaid coverage on December 1. If that’s the case, you should get a letter from your local Department of Social Services office in late November. If you have not gotten this letter before December 15, but you are enrolled in the Medicaid Family Planning Program and you meet the rules for full Medicaid benefits, call your local Department of Social Services office.
Will it be necessary to report work hours report to enroll in Medicaid coverage?
Not at this time. As of now, CMS and the Biden administration have not allowed work reporting requirements as a condition of Medicaid coverage.
When does my Medicaid health coverage begin?
The date coverage begins depends on when you apply for Medicaid. Here are examples of situations people may have:
You apply for Medicaid in December. Your application is not processed until January (or later). But you need care in December. If you are eligible, your Medicaid coverage will be retroactive to December 1. That means if you get care in December, your provider can bill for
services that Medicaid covers. You should not have to pay out of pocket. You may have to pay a copay.
You apply for Medicaid in January 2024 (or later) but have medical bills you need to pay from services you received in December 2023. When you apply for Medicaid, make sure you answer the questions that ask about medical bills from prior months. You can request that your Medicaid coverage be retroactive for up to three months before the month you applied. So, if you
apply in March and you are eligible, Medicaid can pay bills for covered services from December, January and February. Remember, coverage under expansion can only go back to December 2023.
Are non-U.S. citizens eligible for health care coverage through NC Medicaid?
Some non-U.S. citizens can get health coverage through Medicaid. To be eligible you must be:
A person living in North Carolina
A qualified non-citizen for at least five years
This means a person must wait five years after receiving “qualified” immigration status before they can get Medicaid.
There are exceptions. For example, refugees, asylees or lawful permanent residents who used to be refugees or asylees do not have to wait five years.
Individuals without documents are not eligible for Medicaid unless they have an emergency condition as defined under federal law – such as someone in a car accident who is taken to the emergency room.
Under the new rules, how much will people pay in monthly premiums and copays?
You do not have to pay any monthly premiums. Medicaid pays the cost for most health care services. The highest copay is $4 and that is only required for some services.
What information do I need to apply?
Date of birth (photo ID or birth certificate)
Full legal name
Social Security number (or immigration documents)
North Carolina residency (from photo ID, utility bill, lease/mortgage agreement, vehicle registration, or documentation of employment)
Income information (from paystubs, W-2 forms, tax returns, or business records)