North Carolina Medicaid and CHIP income limits, 2026
North Carolina expanded Medicaid, so NC Medicaid covers adults 19 to 64 with income up to $1,836 a month for 1 person (138% of poverty). Children are covered up to $5,940 a month for a family of 4 (216%), and pregnant people up to $3,625 for a household of 2 (201%).
- Medicaid expansion
- Yes
- Work requirement
- By January 1, 2027
- Last verified
North Carolina limits by group, as a percent of poverty
| Group | Limit |
|---|---|
| Adults 19-64 (Medicaid expansion) | 138% |
| Parents and caretaker relatives | Being verified |
| Pregnant | 201% |
| Children under 19, highest limit (Medicaid or CHIP) | 216% |
Percents include the 5% income disregard that Medicaid applies to modified adjusted gross income (MAGI), so the federal 133% standard shows as 138%. Older adults (65+) and people with disabilities have separate, non-MAGI rules not shown here.
Limits for children by age band (under 1, 1-5, 6-18) are being verified; the table shows the highest limit any child can qualify under.
North Carolina monthly income limits by household size
| Household size | Adults 19-64 (138%) | Pregnant (201%) | Children under 19 (216%) |
|---|---|---|---|
| 1 person | $1,836 | $2,674 | $2,873 |
| 2 people | $2,489 | $3,625 | $3,896 |
| 3 people | $3,142 | $4,577 | $4,918 |
| 4 people | $3,795 | $5,528 | $5,940 |
| 5 people | $4,449 | $6,479 | $6,963 |
| 6 people | $5,102 | $7,431 | $7,985 |
| 7 people | $5,755 | $8,382 | $9,008 |
| 8 people | $6,408 | $9,334 | $10,030 |
Percent x the 2026 HHS poverty guideline for the 48 contiguous states and DC / 12, rounded up. North Carolina's own chart may differ by a dollar; the state's chart decides. A pregnant woman counts each expected baby in the household size.
Medicaid work requirement in North Carolina
January 1, 2027 for expansion adults (80 hours a month in 3 of the previous 6 months), along with 6-month renewals (NC Medicaid).
Exemptions in the federal law include parents and caretakers of a child 13 or younger or of a person with a disability, people who are pregnant or postpartum, people who are medically frail, veterans with a total disability rating, and people meeting TANF or SNAP work rules. North Carolina's Medicaid agency will say what you need to report.
North Carolina notes
- North Carolina expanded Medicaid on December 1, 2023.
- North Carolina applies the federal non-citizen restrictions from October 1, 2026.
Other 2025 federal law changes
Public Law 119-21 did not change the income limits above. It changes who stays covered and how:
- Fewer non-citizens qualify for federally funded coverage. Federal Medicaid and CHIP funding is limited to citizens, lawful permanent residents, Cuban and Haitian entrants and citizens of the Compact of Free Association nations. Other lawfully present immigrants, such as refugees and people granted asylum, lose federally funded coverage unless the state pays. From October 1, 2026.
- Renewals every 6 months for expansion adults. Expansion adults must have their eligibility re-checked every 6 months instead of every year. Renewals from January 1, 2027.
- Shorter retroactive coverage. Medicaid can pay medical bills from before you applied for only 1 month (expansion adults) or 2 months (everyone else), instead of 3. Applications from January 1, 2027.
- Cost sharing for expansion adults above the poverty line. Expansion adults with income above 100% of poverty can be charged up to $35 per service, capped at 5% of family income. From October 1, 2028.
How to apply in North Carolina
- Online: ePASS
- North Carolina Department of Health and Human Services, NC Medicaid: NC Medicaid eligibility
- Phone: 1-888-245-0179
- You can apply any time of year. If your income is too high for NC Medicaid, the same application can check you for a subsidized plan on HealthCare.gov or your state's marketplace. Only the North Carolina Department of Health and Human Services, NC Medicaid can decide eligibility.
Sources
- https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels
- https://policies.ncdhhs.gov/wp-content/uploads/MA-3321.pdf
- https://policies.ncdhhs.gov/wp-content/uploads/CN-03-26.pdf
- HHS 2026 poverty guidelines
- Public Law 119-21 (2025)
North Carolina's chart and Medicaid.gov were compared field by field on ; page updated . We re-check every state each spring, after states adopt the new poverty guidelines. See how we verify benefits limits.