Medicaid Expansion
NC Medicaid Now Covers More People in North Carolina.
WNCCHS takes all plans and is accepting new patients!
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Patients like Kate now have a ray of hope, thanks to Medicaid Expansion. Click the image to read Kate's story!
Thanks to Medicaid Expansion, NC Medicaid now covers people ages 19 through 64 with higher incomes, closing the coverage gap for North Carolinians. NC Medicaid pays for doctor visits, yearly check-ups, emergency care and more at little or no cost to participants.
Learn everything you need below, or visit Medicaid.ncdhhs.gov.
NC Medicaid Covers Most Health Services, Including:
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Primary care so you can go to a doctor for a check-up or when you don't feel well
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Hospital services
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Maternity and postpartum care if you are pregnant and after giving birth
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Vision and hearing services
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Prescription drug benefits to pay for medications
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Dental and behavioral health services
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Preventive and wellness services
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Medical devices and other therapies
WNCCHS Medicaid Patients Are Eligible for Even More Benefits!
Including referrals for food boxes, transportation + car repairs, home weathering & renovations, home goods, utility assistance, and legal assistance.
There is no monthly fee and copays are never more than $4.
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!
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You live in North Carolina
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Age 19-64
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You are a citizen. (Some non-US citizens can also get Medicaid health care coverage).
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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 Do I Apply?
Review the eligibility guidelines. If you are not sure if you are eligible, we suggest you apply anyway.
There are many ways to apply. You can apply online, by phone, email, mail, fax, or in person. See below for more details.
You can apply at any time of the year. It can take up to 45 calendar days (or up to 90 calendar days for disability applications) for your local Department of Social Services (DSS) to make a decision on your application. It can take longer if your application is missing information.
Do not wait — apply now. You may be eligible for Medicaid health care coverage for the last 3 months of medical bills starting from the date you apply.
What you must have to apply:
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Full legal name and date of birth, for at least one person applying
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Mailing address, for at least one person applying
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Your signature (digital, voice, or written depending on how you apply
What you may need to apply:
You can save time if you also give the following information:
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Identity documents, such as driver’s license or school ID
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Social Security number (SSN) for people applying who have them, or proof they have applied for one
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Immigration documents for non-U.S. citizens who are applying
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Proof you live in North Carolina, such as a photo ID with your address, a utility bill, a lease, or documentation of employment
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Employer and income information for you and everyone in your household, such as paystubs, W-2 forms, tax returns or business records
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Copies of all medical or life insurance policies
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List of all cars, trucks, motorcycles, boats, etc. you or anyone in your household own, including the year, make, model and vehicle identification number (VIN) for each item
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Most recent bank statements
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List of all real property you own (this includes land, homes and buildings)
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Current financial statements/award letters from other sources of income, such as Social Security, retirement benefits, pensions, veterans benefits and child support
Ways to Apply
For complete details on how to apply, please visit the NCDHHS Medicaid website.
WNCCHS patients, make sure WNCCHS is listed as your health care provider (or “PCP”) when applying! Some patients were also automatically assigned a Primary Care Provider. You can change your PCP for any reason through Aug. 31, 2024. Just call your health plan and request the change; you can find the phone number for your plan on your Medicaid ID Card.
Online
Apply online through NCDHHS's secure website, ePASS. On the application, NC Medicaid is referred to as “Medical Assistance.”
Download ePASS Fact Sheet
In Person
Apply in person at your local Department of Social Services (DSS). Walk-ins are available at all local DSS. You can also schedule an in-person or phone interview.
You can complete an application at your local DSS. Or, you can fill out a printable application (DMA-5200) ahead of time. If you are a single adult without health care coverage from your employer, use the “short form” application (DMA-5201).
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Call
Call your local Department of Social Services (DSS) to apply over the phone.
Use the DSS directory or call the NC Medicaid Contact Center at 1-888-245-0179 to find the location closest to you.
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Online
Download and fill out a printable application (DMA-5200, called the “Application for Health Coverage & Help Paying Costs”).
Remember, you must sign your application.
Then mail, email, fax or bring your application to your local Department of Social Services (DSS). Use the DSS directory or call the NC Medicaid Contact Center at 1-888-245-0179 to find the location closest to you.
Need Help Applying for Medicaid?
There are several ways you can get help applying for Medicaid. Here are some options:
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Make a free appointment with NC Navigator Consortium online or call 1-855-733-3711. They can help you apply for NC Medicaid.
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Call WNCCHS's medical legal partner, Pisgah Legal Services, for help with enrollment: (828) 210-3404
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Stop by WNNCHS—Minnie Jones Health Center at 257 Biltmore Ave. in Asheville, NC, with your supporting documents (see above) and ask for assistance.
Medicaid Plans
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.
NCMedicaidPlans.gov
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.
We recommend you check your account to see which plan and Primary Care Provider is listed for you, since they can be automatically assigned – but you can change either for any reason.
If you want to change your health plan, you have 90 days after Medicaid enrollment to pick a new one. To do so, visit ncmedicaidplans.gov, use the NC Medicaid Managed Care mobile app, or call 1-833-870-5500.
WNC Family Planning Program Update
Many people who were previously enrolled in Medicaid’s limited Family Planning program were automatically enrolled for full NC Medicaid benefits starting December 1, 2023.
Those who are eligible for full Medicaid benefits will
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Get a letter from their local Department of Social Services letting them know they will start getting full Medicaid coverage
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Be assigned a health plan
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Receive a packet from their health plan in the mail that includes a new Medicaid ID card
Additionally, anyone with health coverage through HealthCare.gov will need to cancel their plan once they are enrolled in NC Medicaid.
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. If your income has recently changed and you think you may be eligible, update your information in ePASS (ePASS.nc.gov) or by contacting your local Department of Social Services (DSS). Also, please use ePASS or contact your local DSS office to make sure your contact information is up to date so that you do not miss important information about your benefits.
Frequently Asked Questions
Download NCDHHS's FAQ Document HERE
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.
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When and how do I apply for Medicaid?
You can apply now. 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.
I’m a WNCCHS’s patient who just got Medicaid, but it says I’m assigned to a different provider who’s not at WNCCHS. What does that mean?
When Medicaid Expansion passed, some folks were automatically enrolled in a health plan and assigned a Primary Care Provider or “PCP.” However, you may change your PCP for any reason through Aug. 31, 2024, and we’d encourage you to do so. To change your PCP to your WNCCHS PCP, you need to call your health plan and request the change. You can find the phone number for your plan on your Medicaid ID Card – or tell me the name of your plan and I can look up the number:
• WellCare: 1-866-799-5318 (TTY: 711)
• UnitedHealthcare Community Plan: 1-800-349-1855 (TTY: 711)
• HealthyBlue: 1-844-594-5070 (TTY: 711)
• AmeriHealth Caritas: 1-855-375-8811 (TTY: 1-866-209-6421)
• Carolina Complete Health: 1-833-552-3876 (TTY: 711 or 1-800-735-2962)
• How to change your PCP if you are in NC Medicaid Direct: Call the NC Medicaid Contact Center at 1-888-245-0179.
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.
We recommend you check your account to see which plan and Primary Care Provider is listed for you, since they can be automatically assigned – but you can change either for any reason.
If you want to change your health plan, you have 90 days after Medicaid enrollment to pick a new one. To do so, visit ncmedicaidplans.gov, use the NC Medicaid Managed Care mobile app, or call 1-833-870-5500.
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:
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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:
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A person living in North Carolina
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A qualified non-citizen for at least five years
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This means a person must wait five years after receiving “qualified” immigration status before they can get Medicaid.
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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.
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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.