NC Medicaid Expansion

The North Carolina Medicaid Expansion Began December 1, 2023. Here's what's new:

North Carolina has expanded who can get Medicaid starting December 1, 2023. Adults ages 19 through 64 earning up to 138% of the federal poverty line (e.g., singles earning about $20,000/year or families of three earning about $34,000/year) may be eligible. Current beneficiaries with full Medicaid coverage will not see any changes.  The state expects to expand coverage to approximately 600,000 individuals in North Carolina.

 
Starting December 1, 2023, consumers can complete a Marketplace application to see if they are eligible for Medicaid, or they can apply directly with the state using ePASS.
 
How you can help:
 
Consumers who already enrolled in Marketplace coverage prior to December 1, 2023 who are now eligible for Medicaid will need to resubmit their Marketplace application in order for the Marketplace to determine their eligibility for Medicaid and cancel their Marketplace plan. You can help consumers by resubmitting their application through an approved direct enrollment partner (with documented consent), letting the consumer know how to log into their HealthCare.gov account, or conducting a three-way call with the consumer and the Marketplace Call Center at 1-800-318-2596. You should advise consumers not to cancel their Marketplace plan until they receive information from their new Medicaid health plan and visit healthcare.gov's page for more information. The Marketplace does not automatically redetermine current Marketplace consumers’ eligibility for Medicaid and send their information to the state unless the individual actively creates or updates a Marketplace application. 
 
Consumers can have both a Marketplace plan and Medicaid or CHIP, but they are not eligible to receive advance payments of the premium tax credit or other cost savings to help pay for the Marketplace plan premium and covered services.
 
Where can I get more information?
 
North Carolina has published a helpful fact sheet and Toolkit with resources to help talk to consumers about Medicaid expansion, linked below:

Fact Sheet

Toolkit