North Carolina Medicaid Income Limits 2026: Full Chart

NC Medicaid is health coverage, not a grant, and applying through your county DSS or ePASS costs nothing. To see how North Carolina compares with other states, read our national Medicaid income limits guide.

NC Medicaid Income Limits by Household Size (April 1, 2026)

$3,658 a month is the Medicaid Expansion limit for a family of four, according to NC Medicaid's MA-3321 chart effective April 1, 2026, and that chart is the one county DSS workers use. Every column below is monthly gross income. North Carolina publishes base limits and lists the 5% disregard on a separate row; the "with disregard" column adds the two together.

Source: NC Medicaid MA-3321, MAGI Medicaid and Medicaid Expansion Income Limits, effective April 1, 2026 (revised 4/1/2026). \*The disregard column adds the chart's own 5% disregard row ($66.50 for one person, $137.50 for four) to the 133% limit; it's a Grantsights calculation, not a separate line on the chart. The children's column is the top of NC's MIC range; a pregnant woman living alone counts as a household of two. The parent column is the old MAF-C/N standard, which Medicaid.gov (opens in a new tab) lists at 36% of poverty; most parents now qualify through Expansion instead.

How children's coverage is split by age

North Carolina no longer runs a separate CHIP program (Medicaid.gov (opens in a new tab) lists none), and G.S. 108A-54.3A (opens in a new tab) covers children through 18 up to 211%. The chart still splits children into a lower "N" tier and a higher "1" tier:

Source: NC Medicaid MA-3321, effective April 1, 2026. Both tiers are Medicaid. The tier matters for billing and reporting, not for whether your child is covered.

Yearly equivalents

\\Adult figures are calculated from 138% of the 2026 HHS poverty guideline ($15,960 for one person, $33,000 for four). Children and pregnancy figures are NC Medicaid's April 1, 2026 monthly limits times 12.

Older adults, people with disabilities and Medicare help

Sources: NC Medicaid MA-2252, Non-MAGI Medicaid Income/Reserve Limits, and the DHB-5179 MAABD Eligibility Overview chart (opens in a new tab), both effective April 1, 2026; SSI rates from the CMS 2026 standards chart.

How North Carolina Counts Your Income

2 rule sets decide NC Medicaid, and which one applies to you changes what counts.

MAGI rules (Expansion adults, children, pregnancy, parents, family planning). Income is modified adjusted gross income under 42 CFR 435.603 (opens in a new tab): the adjusted gross income on a federal tax return, plus tax-exempt interest, foreign earned income and untaxed Social Security. Your household usually follows your tax filing: the filer, a spouse and the dependents they claim. Child support you receive, workers' compensation, veterans' disability pay, gifts and most scholarships don't count. There's no reserve (asset) test for any MAGI group; MA-3321 says so in its header.

The 5% disregard. The federal rule subtracts 5% of the poverty line from income when that decides eligibility. NC's April 2026 chart sets it at $66.50 a month for one person, $113.83 for three and $137.50 for four. It only helps if you're just over the base line.

Non-MAGI rules (aged, blind, disabled, Medicare Savings Programs, long-term care). These follow SSI-style counting: Social Security, pensions, wages and interest count, and so do the income and reserves of a spouse. People over the MAABD limit can still get Medicaid as "medically needy" by meeting a deductible: medical bills that bring countable income down to $242 a month for one person or $317 for two.

To make it specific: for example, a family of three in North Carolina earning $3,500 a month in wages is over the $3,028 Expansion limit and over the $3,141.83 figure with the disregard, so the two parents don't qualify on income. Their child is well under the $4,804 limit for children, so the child gets Medicaid at no cost. If the mother is pregnant, the expected baby makes her household four people, and $3,500 is under the $5,390 pregnancy limit, so she'd get full Medicaid through 12 months after the birth.

NC Medicaid Asset Limits: $2,000 for One Person

$2,000 for one person and $3,000 for a couple are NC Medicaid's reserve limits for aged, blind and disabled coverage, according to MA-2252 effective April 1, 2026. The Medicare Savings Programs allow more: $9,950 and $14,910. Workers with disabilities can have up to $32,532.

Countable reserves are things you could turn into cash, such as bank accounts, stocks and bonds; your county DSS decides which property is excluded under NC's ABD manual. Adults applying through Expansion, parents, children and pregnant women have no asset test, so savings won't block them.

Nursing home and long-term care. North Carolina doesn't use the 300% special income cap ($2,982 a month in 2026, per the CMS chart) that many states use. Instead, NC Medicaid's MA-2270 long-term care budgeting policy (opens in a new tab) (revised June 27, 2025) compares your gross monthly income with the nursing facility's Medicaid rate for 31 days. If your income is lower, you can get help with the cost of care. You then pay most of your income to the facility each month (your patient monthly liability), keeping a $70 personal needs allowance, or $140 for a married couple sharing a room.

Under NC's MA-2231 spousal protection rules (opens in a new tab), the spouse at home keeps all assets up to the minimum, half of the couple's assets in the middle range, and no more than the maximum. The manual itself still shows 2025 amounts; the federal 2026 figures above are what the rules index to.

Expansion vs Non-Expansion: North Carolina's Trigger Law and the 2027 Rules

December 1, 2023 is when North Carolina expanded Medicaid to adults 19 to 64 up to 138% of poverty, according to NC Medicaid's expansion page (opens in a new tab). Before that, a single adult without children or a disability couldn't get full Medicaid at any income, and parents faced the $434-to-$744 MAF-C standards above. That's still the situation in a non-expansion state such as Texas.

The trigger law. North Carolina's expansion (NC Health Works in the statutes) has two built-in off switches:

• G.S. 108A-54.3C (opens in a new tab) ends Expansion coverage if the federal match for the group falls below 90%, no earlier than the date the lower rate takes effect.
• G.S. 108A-54.3B (opens in a new tab) ends it if, for any fiscal year, hospital assessments and the other listed sources can't fully pay the state and county share.

In either case the DHHS Secretary must notify legislators, post a notice on the department's website with a proposed end date, and file the paperwork with CMS.

Where it stands on November 3, 2026. Both triggers are still law. The 2025 federal budget law (Public Law 119-21) added work requirements and six-month renewals, which raised administrative costs. Session Law 2026-1 (opens in a new tab) (House Bill 696, ratified April 28 and signed April 30, 2026) says lawmakers intend to pay those costs from a source that meets the G.S. 108A-54.3B limits, and it shifts hospital assessment money to do that. Grantsights found no discontinuation notice on NC Medicaid's website, and NC Medicaid's own pages describe Expansion continuing with new rules in 2027. A future cut to the 90% federal match would still trip the first trigger.

What changes on January 1, 2027. NC Medicaid's work and community engagement page (opens in a new tab) (updated October 13, 2026) and G.S. 108A-55.7 (opens in a new tab) say:

• Most adults 19 to 64 must earn at least $580 a month or log 80 hours of work, school, job training or volunteering.
• New applicants must show they met it for three months in a row before the month they apply. That's stricter than the federal minimum.
• Current members must show 3 of the 6 months before their renewal, and renewals move to every 6 months.
• Exemptions include parents and caregivers of a child under 14, pregnancy and 12 months after, Medicare or SSI/SSDI recipients, people who are medically frail or in addiction treatment, former foster youth under 26, tribal members and people meeting SNAP or Work First work rules.
• Retroactive coverage shrinks: on applications filed on or after January 1, 2027, most Expansion adults can get 1 month before the application instead of 3, according to NC Medicaid's Medicaid is changing page (opens in a new tab).

None of this changes the income limits. It also doesn't touch children, pregnancy coverage, ABD Medicaid or people 65 and older. Separately, some non-citizens lost coverage starting October 1, 2026, when state law limited non-citizen coverage to what federal law requires.

What NC Medicaid's Charts Don't Tell You

Grantsights found 6 things the official charts leave out or make easy to misread:

1. The Expansion row stops at 133%. MA-3321 prints $1,769 for one person and puts the 5% disregard on a separate line at the bottom. NC Medicaid's expansion page rounds the result to "about $1,800" for a single adult. Someone earning $1,800 is over the printed line but under the $1,835.50 working limit.
2. The ABD overview chart has an old number. DHB-5179, dated April 1, 2026, shows the SLMB (MQB-B) range for one person as $1,330.01 to $1,565. MA-2252 shows $1,596 for 2026; $1,565 was the 2025 figure. Use MA-2252.
3. An older MA-2252 copy lists the wrong Medicare Savings Program reserve. One posted April 2026 version shows $9,650 for one person; the corrected chart says $9,950, which matches the CMS 2026 standard.
4. The Medicaid.gov table (opens in a new tab) is dated December 1, 2023. Its percentages (211% for children, 196% for pregnancy, 133% for Expansion) still match NC's 2026 chart, but use MA-3321 for dollar amounts.
5. North Carolina's update date isn't January. HHS publishes poverty guidelines in January, but G.S. 108A-54.3A(b) (opens in a new tab) has NC apply them each April 1. Between January and March, sites quoting new federal figures are ahead of what DSS uses.
6. A termination for missing paperwork can be undone. NC Medicaid's Change Notice 08-26 (opens in a new tab) (effective October 1, 2026) refers to a 90-day reopen period: if you send the missing information within 90 days, the county can reopen the case.

Grantsights analysis of NC Medicaid's April 1, 2026 MA-3321 chart found that children in a family of four stay covered up to $5,803 a month, $2,145 above the $3,658 Expansion line for their parents. And NC's 100% ABD limit of $1,330 is $336 a month above the $994 SSI rate, so many older North Carolinians who don't get SSI can still qualify for full Medicaid.

Common Mistakes and Red Flags

These 6 errors cost North Carolinians coverage they could have had:

• Common mistake: comparing take-home pay with the chart. The chart uses gross income. Pre-tax retirement contributions and health premiums come off; tax withholding doesn't.
• Counting child support as income. Under MAGI rules it doesn't count.
• Assuming savings disqualify you. Expansion adults, parents, children and pregnant women have no asset test.
• Applying only for the adults. At 211% of poverty, children qualify at much higher incomes than their parents. Apply for everyone in the household.
• People underestimate how far the pregnancy limit goes. At 196%, a household of three can earn up to $4,463 a month. Report a pregnancy to your DSS as soon as you know.
• Red flag: anyone charging to apply. Applying is free. NC Medicaid's recertification fact sheet (opens in a new tab) warns about scam letters and tells you to check with your local DSS if mail asking for information didn't come from them. A website or caller asking for a fee, a gift card or your NCID password isn't part of the program.

How to Apply for NC Medicaid and How Long It Takes

4 free ways to apply, according to NC Medicaid's how to apply page (opens in a new tab):

• Online: ePASS (opens in a new tab), which needs an NCID login. You can apply for Food and Nutrition Services on the same site.
• In person: your county Department of Social Services, which you can find in the NCDHHS local DSS directory (opens in a new tab). Walk-ins are accepted; calling ahead for an interview is recommended.
• By phone: call your county DSS. The NC Medicaid Contact Center, 1-888-245-0179 (TTY 711), answers general questions.
• By mail, email, fax or drop-off at your county DSS.

You can also apply through HealthCare.gov (opens in a new tab), which sends Medicaid-eligible applications to the state. Have ID, proof of North Carolina residency, pay stubs or a tax return, Social Security numbers and immigration documents for anyone applying who isn't a citizen.

How long it takes. NC Medicaid says DSS can take up to 45 days to decide an application, and up to 90 days when disability is involved, matching the federal standard in 42 CFR 435.912 (opens in a new tab). If you apply by December 31, 2026, coverage can reach back up to 3 months before the application month if you were eligible then.

What to Do If You're Denied

60 calendar days from the date on your notice is your deadline to ask for a hearing, according to NC Medicaid's MA-3430 Notice and Hearings Process (opens in a new tab); with good cause, the county can accept a request up to 90 days out. Here's how it works:

• Call, write or use ePASS to tell your county DSS caseworker you want a hearing.
• For most issues, a local hearing at the county comes first. If you disagree with the local decision, you have 15 calendar days from its mailing to ask for a state hearing.
• Disability decisions go to a State Hearing Officer.
• If you already have Medicaid and appeal a cut or termination within 10 business days of the notice, your coverage can continue until the local hearing decision. Applicants who were denied don't get continued coverage, because there's nothing to continue.
• State hearings can be held in person at the DSS office, by phone or by video, and the choice is yours, per Change Notice 08-26.

If your coverage ended because a renewal form never came back, sending the missing information within 90 days is usually your best bet, since it may reopen your case faster than an appeal.

If You're Over the NC Medicaid Limit

3 main routes cover most North Carolinians who earn too much for Medicaid:

• Coverage for the kids and for pregnancy. Children qualify up to 211% ($5,803 a month for four) and pregnant women up to 196%, so check them even if the adults don't qualify.
• The Marketplace. Adults over 138% of poverty can buy a plan through HealthCare.gov and may get premium tax credits. The NC recertification fact sheet points people who lose Medicaid there.
• Medicare help for people 65 and older or on disability Medicare. The Medicare Savings Programs pay Part B premiums up to $1,796 a month for one person (QI), with reserves up to $9,950. The medically needy deductible can also cover large medical bills. Our help for seniors guide, SSI income limits guide and disability grants guide cover related programs.

North Carolina's family planning Medicaid (MAF-D) goes up to 195% of poverty, $2,594 a month for one person, for adults who don't qualify for full coverage.

For neighboring states with similar rules, compare our Virginia, Ohio, Michigan and Pennsylvania guides.

If you're applying for Medicaid, it's worth checking food help on the same ePASS application. Our North Carolina food stamps guide covers FNS limits, our WIC income limits guide covers pregnant women and young children, and our federal poverty guidelines guide explains the numbers behind these charts. Families paying for care can see our child care assistance guide.

Curious what else a North Carolina household like yours might qualify for? The Grantsights free eligibility checker lists official programs to look at next. It can't approve or deny Medicaid and won't apply on your behalf; that decision belongs to your county DSS.

FAQ: North Carolina Medicaid Income Limits

What is the income limit for NC Medicaid in 2026?

For adults 19 to 64, $1,769 a month for one person and $3,658 for four at 133% of poverty, or about $1,836 and $3,796 with the 5% disregard, effective April 1, 2026.

What is the income limit for children?

211% of poverty: $4,804 a month for a family of three and $5,803 for four.

Does NC Medicaid have an asset limit?

Only for aged, blind and disabled coverage and long-term care: $2,000 for one person and $3,000 for a couple.

Is NC Medicaid expansion ending?

Not as of November 3, 2026. The trigger laws remain, but no discontinuation notice has been posted.

When do work requirements start?

January 1, 2027, for Expansion adults who aren't exempt.

What's the NC Medicaid appeal deadline?

60 calendar days from the date on the notice, or up to 90 days with good cause.

Sources

1. NC Medicaid: MA-3321, MAGI Medicaid and Medicaid Expansion Income Limits (opens in a new tab), effective April 1, 2026
2. NC Medicaid: MA-2252, Non-MAGI Medicaid Income/Reserve Limits (opens in a new tab), effective April 1, 2026
3. NC Medicaid: Change Notice 03-26, 2026 Federal Poverty Level Income Changes (opens in a new tab), February 3, 2026
4. NC Medicaid: DHB-5179, MAABD Eligibility Overview Chart (opens in a new tab), effective April 1, 2026
5. NC Medicaid: MA-2270, Long Term Care Need and Budgeting (opens in a new tab), revised June 27, 2025
6. NC Medicaid: MA-2231, Community Spouse Resource Protection (opens in a new tab), revised December 2, 2024
7. NC Medicaid: MA-3430, Notice and Hearings Process (opens in a new tab), revised February 1, 2024, and Change Notice 08-26 (opens in a new tab), effective October 1, 2026
8. NC Medicaid: North Carolina Expands Medicaid (opens in a new tab)
9. NC Medicaid: The Work and Community Engagement Requirement (opens in a new tab), last modified October 13, 2026
10. NC Medicaid: Medicaid Is Changing in 2026-27 (opens in a new tab)
11. NC Medicaid: How to Apply (opens in a new tab), last modified October 8, 2026, and How NC Medicaid Eligibility Recertification Works fact sheet (opens in a new tab)
12. North Carolina General Statutes: G.S. 108A-54.3A (opens in a new tab), G.S. 108A-54.3B (opens in a new tab), G.S. 108A-54.3C (opens in a new tab) and G.S. 108A-55.7 (opens in a new tab)
13. North Carolina Session Law 2026-1 (House Bill 696) (opens in a new tab), signed April 30, 2026
14. Medicaid.gov: Medicaid, CHIP and BHP Eligibility Levels (opens in a new tab), as of December 1, 2023
15. CMS: Updated 2026 SSI and Spousal Impoverishment Standards (opens in a new tab), April 27, 2026: SSI $994 individual and $1,491 couple; 300% cap $2,982
16. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab): $15,960 for one, $27,320 for three, $33,000 for four, plus $5,680 per extra person
17. eCFR: 42 CFR 435.603, MAGI methodology (opens in a new tab) and 42 CFR 435.912, timeliness standards (opens in a new tab)