Changes are coming to NC Medicaid. Read on to learn how you could be affected.
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What North Carolinians Need to Know
Starting January 1, 2027, some people on NC Medicaid will need to prove to the state that they're working, in school, volunteering, or completing job training in order to keep their health insurance.
Who Is Affected
Many adults ages 19–64 covered by NC Medicaid will need to meet new work requirements to keep their coverage unless they qualify for an exemption.
Who Is Exempt
Exemptions include people younger than 19 or older than 64; pregnant people or those within 12 months of the end of a pregnancy; American Indians/Alaska Natives; parents or caretakers of children 13 and under; individuals who have a mental, substance use, or physical condition that impairs their ability to work; and several other groups. To see a full list, please follow the links below.
Timeline
North Carolina Resources
ePASS
Apply for coverage, update your contact information, and check your benefits online.
epass.nc.gov →Medicaid is Changing
North Carolina's official overview of what's changing and when.
medicaid.ncdhhs.gov →NC Medicaid Work & Community Engagement
NC Medicaid's official page on what's changing, who's exempt, and how to meet the requirement.
medicaid.ncdhhs.gov →Local Department of Social Services (DSS)
Contact your county DSS for in-person help determining whether you're exempt or subject to the requirements.
ncdhhs.gov →North Carolina Frequently Asked Questions
Due to new policies out of D.C., a number of changes will be coming over the coming months that could impact you, depending on your immigration status, work/school/volunteer qualifications, and more. You will begin to learn more from North Carolina in the coming weeks and be prepared to take action to make sure your NC Medicaid policy is protected.
Yes, many NC Medicaid Expansion recipients ages 19 through 64 are subject to new federal requirements.
North Carolina’s official website explains who is affected, and beneficiaries are encouraged to contact their local Department of Social Services to confirm whether they’re exempt or subject to the requirements and to keep documentation of their status. Make sure your contact information is up to date so you receive any notices. Sign up for notifications from Keep Your Care and we’ll send you a reminder as deadlines approach.
The new work requirements will go into effect beginning January 1, 2027. Individuals up for renewal in 2027 will be required to come into compliance with work requirements at their scheduled renewal date. When individuals are up for renewal, the state will either renew based on existing data or request information from the individual to support their renewal. NC Medicaid will check every 6 months, when your Medicaid is renewed. You must meet the requirement for 3 out of 6 months leading up to each renewal. If you do not, you will lose your Medicaid coverage. Sign up for updates and we’ll notify you as deadlines approach.
A full list of exemptions can be found on the North Carolina Department of Health and Human Services website, but some people are automatically exempt, including: children 18 years old or younger, parents or caretakers of children 13 and under, people with disabilities, pregnant people or those within 12 months of the end of a pregnancy, and those 65 and older. If you fall into any of these categories, it is recommended that you check the NC Medicaid website for more information.
Most enrollees will need to document a qualifying exemption; at least 80 hours per month of employment, job training, and/or volunteering; attend school half-time; or earn at least $580 a month (you only need to meet one). Important: North Carolina does not accept self-attestation (your word alone) as the only proof, and you must show you met the requirement for at least three of the six months before your renewal, so keep documentation of your status.
ePASS is North Carolina’s official online portal to apply, update your account, and check your benefits. The NC Medicaid Contact Center (888-245-0179) can help by phone. You can also contact your local Department of Social Services for in-person help, or sign up with Keep Your Care and we’ll keep you up to date as deadlines approach.
NC Medicaid will check every six months, when your Medicaid is renewed (“recertification”). You must meet the requirement for three out of six months leading up to each recertification. If you do not, you will lose your Medicaid coverage.
North Carolina has a rule that you can’t just tell the state you’re working, in school, or volunteering — you have to show something that proves it. This could be a pay stub, a school schedule, or a note from whoever you volunteer with. Keep copies of these papers somewhere safe so you have them ready. If you’re not sure what counts as proof, contact your local Department of Social Services — they can walk you through it.
Federal and state requirements and deadlines are still changing.
Sign up for updates and we'll be sure to notify you about any North Carolina-specific updates as they are released.