Guide to Medicaid Expansion in
North Carolina

Medicaid is a public health insurance program for low-income people. Provides free coverage in different medical disciplines. Among others, primary care to be able to go to the doctor if you feel bad. Also hospital services if you need hospitalization. In the case of pregnant women, maternity and postpartum care. It even covers access to specialists in areas such as vision and hearing. And it provides benefits to pay for prescription medications, among other aspects.

It means it will reach many more people in the state. According to official calculations, with the expansion of Medicaid About 600,000 people will obtain health coverage who did not have health insurance, of which more than 50,000 belong to the Latino community.

Before this expansion, Medicaid in North Carolina was only available to children under 18, adults over 65, pregnant women, and the disabled. In other words, adults between the ages of 19 and 64 without children could not access it, no matter what their salary was.

In addition, there was a minimum wage, and if a person met the other requirements, but earned less than that amount, they were also excluded. With expansion, that situation will change.

How many Latinos in NC will benefit from Medicaid expansion 

At least 50,000 belong to the Latino community.

Medicaid covers most health services. Here are some examples:

• Primary care: for example, to go to the doctor if you feel unwell or for routine check-ups
• Hospital services: for example, for single-day or multi-day stays
• Maternity and postpartum care
• Vision and hearing services
• Benefits to pay for your prescription medications
• Preventive and wellness services
• Dental and oral health services
• mental health services

Simply put, it covers doctor visits, annual routine checkups, emergency care, and mental health, to name a few examples.

But... How much does all this cost?

In some cases, however, you will have to pay copays to visit the doctor or for certain medication prescriptions. But those co-payments are very low: they never exceed $4 (again you read correctly: four dollars for a doctor's visit).

They will be eligible people who meet the following requirements:

• Residing in North Carolina.
• Be from 19 to 64 years old.
• Be a citizen (there are some exceptions to this point, which we will explain later)
• There will be no salary floor to access. Anyone who earns less than 138% of the federal poverty level will be able to get coverage. That means:

From December 1, 2023.

The answer is: it depends. If you are not a citizen, you can access Medicaid as long as you live in North Carolina and have a “qualified immigration status”.

Qualified immigration status includes:

• Legal Permanent Residents (Holder of the Green card) 
• Asylees 
• Refugees 
• Cuban/Haitian participants 
• On parole in the US for at least one year 
• Conditional entry granted before 1980 
• Non-citizens, spouses, children or abused parents 
• Victims of trafficking and your spouse, child, sibling or parent or persons with a pending application for a trafficking victim visa 
• Deportation withholding granted 
• Member of a federally recognized Indian tribe or American Indian born in Canada 
• Citizens of the Marshall Islands, Micronesia, and Palau living in one of the US states or territories (known as Compact of Free Association or COFA immigrants)

In any case, if you are not a citizen but have “qualified immigration status,” you may not be able to obtain Medicaid until 5 years have passed since you received that status.

If you are in a hurry and have little time, we can give you a concrete, simple and blunt answer to that question: NO. Receiving Medicaid will not affect your chances of obtaining citizenship in the future. The only exception is in special cases in which prolonged medical care is required, such as very extensive hospitalizations.

In case you want to know a little more for peace of mind, allow us to share some details with you. The "public charge rule” is a rule that enables immigration authorities to deny permanent legal residence to immigrants considered “dependent” on government assistance to survive. But the truth is that currently there is practically no government aid program that can bind you. Because? Because the programs that could cause someone to be considered a “public charge” are only available to citizens. This means that people with other immigration statuses cannot even use them and, therefore, are not at risk.

In that sense, Medicaid is not considered a public charge and will not cause any problems for you to regularize your status. The only exception is if you require a very long hospitalization.

If you are undocumented, you do not qualify for Medicaid but you can get temporary coverage for emergency conditions in a hospital.

You also have other alternatives, such as accessing community clinics where you will receive free care.

Here You'll also find affordable health care without health insurance. For more information about uninsured care you can call 301-443-5636.

As Yazmin García Rico explained to us, all those people who were not eligible must register and will become so now that the expansion of Medicaid has been achieved in North Carolina.

On the other hand, those who currently have Medicaid family planning benefits do not have to do anything and You will get coverage automatically after expansion. In those cases, they will receive a new Medicaid insurance card and a notification in the mail that they have the new services. Approximately 300,000 people will be automatically enrolled.

In that case you should not worry since you will not have to do any new procedures nor will you lose coverage.

If you want to take advantage of the Medicaid expansion in North Carolina you have 4 options to enroll:

Online through ePASS

Through a application printed on paper (available in Spanish)

In person, at your Department of Social Services (here you will find the location)

By phone by calling your Department of Social Services office (here you will find the telephone numbers)

Let us give you a little advice: in the event that you are not sure whether you are eligible or not, we recommend that you complete your application and, in any case, they will then inform you of the result of your procedure.

Additionally, you will see that in the registration application they ask you to complete several personal information. But do not worry. You can leave blank spaces and fill out minimal information, and a social worker will contact you later to help you add the necessary data. Obviously, if you complete all the information the process will be much faster.

Another tip from Yazmin García Rico, from NCDHHS

“We encourage registration through ePASS. It is the fastest way to process the request. But the other forms of registration are also perfectly valid.”

When you complete your application through any modality, you must have some documentation. For example, to prove your income, that you live in North Carolina, or that you have eligible immigration status.

Yazmin García Rico, from the health department, explained to us that the time varies from person to person. It depends, to a large extent, on whether the person is used to using the Internet. But it is generally estimated that it could take you 1 hour.

45 days maximum.

However, it's important to note that you don't need to complete the application all at once. The application is saved automatically. You can also save your application by clicking "Save and Exit." When you return to the application, it will take you back to the section you last completed.

If you are approved for Medicaid, you will be able to choose from several plans, although they all have more or less the same coverage. The only difference is that each has its own network of doctors and professionals. Therefore, you may want to check the lists of doctors to see if there is one of your preference in any plan.

Additionally, you will receive a card from your health plan in the mail.

In that case you will not be able to access Medicaid but it is very likely that you will be able to qualify to purchase a subsidized insurance in the health insurance market. This is an alternative that, although it is not free, is very cheap and convenient.

As NCDHHS experts explained to us, agricultural workers on H2-A visas are potentially eligible if they are pregnant women or under 19 years of age. 

All other people are eligible to receive emergency services from Medicaid (for example, in cases of accidents).

Yes of course! If they are over 18, they can submit the same Medicaid application and answer the disability question, if they can do it themselves. The local DSS will need to complete a medical evaluation and request medical records to send to Disability Determination Services. If they need help, they can contact their local DSS for help and/or they can also ask someone of their choice to help them with the application, such as a parent.

You can apply online through ePASS. The site itself has a Spanish version, which you will easily find.

You can also submit it in person at your local DSS office by downloading the application in Spanish biting hereIn turn, you can get a free registration appointment with an expert Navigator. Appointments can be scheduled online biting here or by phone at 1-855-733-3711. Navigators can help with Marketplace and Medicaid applications, and services are available in more than 20 languages. Appointments through the end of the year can be booked now.

click here to find an informative video in Spanish.

No. Medicaid is only available to U.S. citizens or non-citizens with “qualified immigration status.”

DACA and TPS are not included in “qualified immigration statuses.” However, the following are eligible:

• Legal Permanent Residents (Holder of the Green card) 
• Asylees 
• Refugees 
• Cuban/Haitian participants 
• On parole in the US for at least one year 
• Conditional entry granted before 1980 
• Non-citizens, spouses, children or abused parents 
• Victims of trafficking and your spouse, child, sibling or parent or persons with a pending application for a trafficking victim visa 
• Deportation withholding granted 
• Member of a federally recognized Indian tribe or American Indian born in Canada 
• Citizens of the Marshall Islands, Micronesia, and Palau living in one of the US states or territories (known as Compact of Free Association or COFA immigrants) 

However, DACA and TPS recipients may be eligible for emergency Medicaid. For example, if they have a traffic accident and are taken to the hospital.

Yes, parents with American citizen children can register them. Applications for Medicaid require information about citizenship and immigration status only of the people who will be beneficiaries. For this reason, the status of the parents is not relevant. Health Department specialists encourage mixed immigration status families to register their eligible children without fear.