Where to start your Medicaid application in North Carolina

You apply for Medicaid in North Carolina through the Department of Health and Human Services (DHHS), which runs the program statewide. The easiest way to begin is online through the NC FAST portal at ncfast.dhhs.gov, where you can submit your application without visiting an office. You can also apply by mail, phone, or in person at your county Department of Social Services office.

Before you start, gather documents that show your income, citizenship, and residency. The DHHS website lists exactly what you need based on your situation — whether you're applying as an individual, parent, child, or senior. Having these ready speeds up the process and reduces delays.

Key Takeaways

  • Apply online through NC FAST (ncfast.dhhs.gov), by mail, phone, or at your county DSS office — online is fastest and requires no office visit.
  • You need proof of income, citizenship, and North Carolina residency, plus details about household size and any medical expenses you pay.
  • The state processes most applications within 30 days, but complex cases or missing documents can extend this to 45 days.
  • Your county DSS office can tell you immediately whether you likely meet income limits, which vary by household size and program type.
  • If you're denied, you have the right to request a hearing within 30 days — the DHHS will explain how in the denial letter.

What documents you need to have ready

North Carolina requires proof of three things: income, citizenship, and residency. For income, bring recent pay stubs (usually the last 30 days), tax returns, or a letter from your employer stating your wages. If you receive benefits like Social Security, unemployment, or child support, bring statements showing those amounts. If you're self-employed, bring tax returns from the last two years.

For citizenship, you need a birth certificate, passport, or naturalization papers. For residency, a utility bill, lease, mortgage statement, or government mail with your current North Carolina address works. If you're applying for a child, bring their birth certificate and proof they live with you.

Some situations require extra documents. If you're over 65 or disabled, bring medical records or a letter from your doctor. If you pay for medical care out of pocket (like insulin or dialysis), bring receipts or statements — these can lower your income limit. Keep copies of everything you submit.

How to apply online through NC FAST

Go to ncfast.dhhs.gov and click "Create Account" if you don't have one. You'll enter your email, create a password, and verify your email address. Then log in and select "Apply for Benefits." The system will ask you to choose which programs you're applying for — select Medicaid and any others you need.

The form asks about household members, income, expenses, citizenship, and residency. Answer each section completely; leaving fields blank causes delays. Upload documents directly into the portal as you go, or upload them all at the end. The system accepts PDFs, photos, and scans. After you submit, you'll get a confirmation number — save this.

NC FAST will show you the status of your application once it's received. You can check it anytime by logging back in. The DHHS will contact you by mail or phone if they need more information.

Applying by mail, phone, or in person

To apply by mail, download the application form from the DHHS website or call your county DSS office to request one. Fill it out completely, attach copies of your documents, and mail it to your county DSS office. Include your phone number so they can reach you with questions. Mail takes longer than online — allow extra time for delivery and processing.

To apply by phone, call your county DSS office and ask to speak with an intake worker. They'll ask the same questions as the online form and tell you what documents to mail or bring in. This route works if you don't have internet access or prefer speaking to someone directly.

To apply in person, visit your county Department of Social Services office during business hours. Bring all your documents and be prepared to wait. An intake worker will help you fill out the form and may be able to scan your documents on the spot. This is the fastest way to ensure your documents are received correctly.

How long approval takes and what happens next

North Carolina has 30 days to process most Medicaid applications from the date they receive it. If your application is complete and straightforward, you may hear back in two to three weeks. If the DHHS needs more information, they'll contact you and give you 10 days to respond; this extends the timeline to 45 days total.

If you're approved, you'll receive a notice in the mail explaining your coverage type and start date. Coverage usually begins on the first day of the month after approval, though some programs cover retroactively (back to the date you applied). Your Medicaid card will arrive separately within one to two weeks.

If you're denied, the notice will explain why and tell you how to request a hearing. You have 30 days from the date on the notice to ask for one. At a hearing, you can present new information or challenge the DHHS's decision. Many people win on appeal, especially if they can provide additional income or expense documentation.

Income limits and what counts as income

North Carolina's Medicaid income limits depend on your household size and which program you're applying for. Parents and children have different limits than seniors and people with disabilities. The DHHS website shows current limits, but they change yearly. Your county DSS office can tell you your specific limit over the phone in minutes.

Income includes wages, self-employment earnings, Social Security, unemployment benefits, child support, and rental income. It does not include food stamps, housing assistance, or most tax refunds. Some income is excluded entirely — for example, the first $65 of monthly earnings and $20 of unearned income don't count. If you're over 65 or disabled, medical expenses you pay out of pocket can reduce your countable income, sometimes dramatically.

If your income is slightly above the limit, ask your county office about medically needy programs, which allow higher income if you have significant medical bills. These programs exist specifically for people in your situation.

What to do if your application is delayed or denied

If 30 days have passed and you haven't heard anything, call your county DSS office and ask for the status. Provide your confirmation number if you applied online. The office can tell you whether your application is still being processed, whether they're waiting for documents from you, or whether it's been approved and your card is in the mail.

If documents are missing, the DHHS will contact you, but sometimes mail gets lost. If you don't hear back within a week of submitting, call to confirm they received everything. If they say documents are still missing, ask exactly which ones and resubmit them immediately.

If you're denied, read the notice carefully — it explains the specific reason. Common reasons are income too high, failure to prove citizenship or residency, or not meeting age or disability requirements. If you believe the decision is wrong, request a hearing. You don't need a lawyer, though you can bring one. At the hearing, you can present new documents and explain your situation to a neutral decision-maker.

Frequently Asked Questions

Can I apply for Medicaid if I'm not a U.S. citizen?

It depends on your immigration status. U.S. citizens and certain legal permanent residents can apply. Undocumented immigrants are not may be able to access for regular Medicaid, though North Carolina does cover emergency medical care for anyone regardless of status. Contact your county DSS office to discuss your specific situation.

How do I know if I make too much money for Medicaid?

Call your county DSS office and tell them your household size and monthly income. They can tell you in minutes whether you're within the limit for any Medicaid program. Income limits vary by program, so you might not may have access to for one but could for another.

What if I'm waiting for my Medicaid card but need to see a doctor now?

Once you're approved, you can use your Medicaid coverage immediately, even before your card arrives. Bring the approval letter to your doctor or pharmacy and they can verify your coverage. Some providers can look it up in the system using your Social Security number.

Can I apply for my child if I don't have custody?

No. The person applying must be the child's parent or legal guardian. If someone else has custody, they must apply. If custody is shared, either parent can apply, but only one application should be submitted to avoid confusion.

What happens if my income changes after I'm approved?

You must report changes within 10 days. If your income increases above the limit, your coverage may end. If it decreases, you might become may be able to access for a different program with better benefits. Call your county DSS office or log into NC FAST to report the change.