How to Sign Up

Application

There are different ways to apply for NC Medicaid:

• Online using North Carolina ePASS. North Carolina ePASS lets you apply for other programs, like Food and Nutrition Services (FNS) or Work First (WF), at the same time. Note: On the ePASS website, NC Medicaid is called "Medical Assistance."
• Online using HealthCare.gov, an online one-stop shop where you can learn about your public and private coverage options.
• In person at your local Department of Social Services (DSS) office. You can also call them to apply over the phone.
• Using a paper application and faxing or mailing it in to your local Department of Social Services (DSS) office.

No matter how you apply, it is important to know that if you are not eligible for NC Medicaid, you may be able to get private insurance subsidized by the government.

Note: If you get Supplemental Security Income (SSI) or are on SSI 1619(b), you don’t need to apply; you’ll get NC Medicaid coverage automatically.

Retroactive Coverage

When you apply for NC Medicaid, you can ask to have your coverage begin up to three months before the month you apply, as long as you were also eligible for NC Medicaid in those months. So if you apply for NC Medicaid in April but have unpaid medical bills from the previous three months (January, February, and March), you could have NC Medicaid pay for those medical bills.

Staying on NC Medicaid

Usually, once you are approved for NC Medicaid, you will continue to get it for 12 months if your situation does not change. If your income, immigration status, residency, or household size changes, update your information with your local Department of Social Services (DSS) office. You can also use North Carolina ePASS to report changes to your situation if you sign up for an Enhanced Account.

When you report your changes, your caseworker or the ePASS site will tell you whether you will continue getting NC Medicaid or if you have new health coverage options. There will always be at least one health coverage option for your family.

If You Get SSI, You Get NC Medicaid Automatically

If you get Supplemental Security Income (SSI), you get NC Medicaid automatically. You don’t have to fill out any additional paperwork. Read DB101’s SSI article for more information about whether you qualify for SSI.

Staying on NC Medicaid through SSI 1619(b) if Your SSI Benefits End

If your SSI benefits go to zero because you go back to work, an SSI rule called 1619(b) lets you keep your NC Medicaid coverage if you:

• Were eligible for SSI benefits for at least one month
• Need NC Medicaid coverage to keep working
• Still meet all the other SSI requirements, such as being disabled and having resources below $2,000, and
• Make less than $46,540 in gross income per year.
  • If your earnings are over this limit and you have high medical expenses, you might still qualify for 1619(b). Ask your local Social Security office about the 1619(b) Individualized Earnings Threshold.

For additional information, read the DB101 SSI article, check out Social Security’s webpage on 1619(b), or talk to a benefits planner.

Note: If you don’t qualify for NC Medicaid through 1619(b) because your income or resources are too high, you may qualify for Health Coverage for Workers with Disabilities (HCWD). Read DB101’s HCWD article to learn more.