Last Updated: February 13, 2026
In 2026, North Carolina Medicaid covers adults earning up to $1,800 per month (138% FPL) for a single person. Children, pregnant women, and seniors qualify at different income levels.
These limits come from the NC Department of Health and Human Services.
Quick summary of this article:
- NC Medicaid income limits by family size for 2026
- Who qualifies under Medicaid expansion rules
- Income charts for adults, children, and pregnant women
- Asset limits for seniors and long-term care
- How NC Medicaid counts your income
- Steps to apply for NC Medicaid today
What Are North Carolina Medicaid Income Limits?
Medicaid income limits are the most you can earn and still get free health coverage. North Carolina sets these limits based on the Federal Poverty Level (FPL). The FPL changes each year.
For 2026, the FPL for one person is $15,650 per year. Bigger families have higher limits. NC Medicaid uses a method called Modified Adjusted Gross Income (MAGI) to count your income.
How the FPL Works
The FPL is a number set by the federal government. It measures income for a household. Medicaid uses a percentage of the FPL as cutoff points.
For example, 138% of FPL means about $21,597 per year for one person. That equals roughly $1,800 per month.
Why Limits Changed After Expansion
North Carolina expanded Medicaid in December 2023. Before that, many adults could not get coverage. Now, adults ages 19 to 64 can qualify if income is low enough. This closed the “coverage gap” for thousands of residents.
If you want to compare these numbers with other states, check our guide on Medicaid income limits by state for 2026.
2026 NC Medicaid Income Limits by Family Size
Here are the official monthly income limits. All amounts are before taxes. These figures are current until April 1, 2026, per the NC DHHS eligibility page.
Adults Ages 19–64 (Expansion Medicaid)
| Family Size | Monthly Income Limit |
|---|---|
| 1 | $1,800 |
| 2 | $2,433 |
| 3 | $3,065 |
| 4 | $3,698 |
| 5 | $4,340 |
The income limit for this group is 138% of FPL. There is no asset test. You can own a home, car, and savings.
Children Ages 0–18
| Family Size | Monthly Income Limit |
|---|---|
| 1 | $2,752 |
| 2 | $3,719 |
| 3 | $4,686 |
| 4 | $5,645 |
| 5 | $6,621 |
Children qualify at 216% of FPL. This is much higher than the adult limit. There is no asset test for children.
Pregnant Women
| Family Size | Monthly Income Limit |
|---|---|
| 1 | $3,455 |
| 2 | $4,353 |
| 3 | $5,252 |
| 4 | $6,150 |
| 5 | $7,048 |
Pregnant women qualify at 201% of FPL. The unborn child counts as a family member. Coverage lasts up to 12 months after birth.
Adults Ages 65 and Older
| Family Size | Full Medicaid | Other Programs |
|---|---|---|
| 1 | $1,305/mo | $1,761/mo |
| 2 | $1,763/mo | $2,380/mo |
Seniors may also qualify for Medicare Savings Programs. Asset limits apply to this group. Learn more about North Carolina Medicaid eligibility 2026 for detailed rules on senior coverage.
What Income Counts for NC Medicaid?
NC Medicaid does not count all your money. Only certain types of income matter. Here is a simple breakdown.
Income That Counts
- Wages and salary (before taxes)
- Self-employment earnings
- Social Security benefits
- Unemployment payments
- Tips and bonuses
Income That Does NOT Count
- Supplemental Security Income (SSI)
- Child support you receive
- VA disability payments
- Pell grants and school aid
- Children’s disability payments
This means your total income may be lower than you think. Many people qualify even when they expect not to.
Asset Limits for NC Medicaid in 2026
Most NC Medicaid groups have no asset test. This includes the expansion of adults, children, and pregnant women. You can have savings, a car, and a home.
However, seniors and people with disabilities face asset limits. Long-term care Medicaid also has strict rules.
Long-Term Care Asset Rules
| Rule | 2026 Limit |
|---|---|
| Single person asset limit | $2,000 |
| Married couple (both applying) | $3,000 |
| Spouse resource allowance (max) | $162,660 |
| Spouse resource allowance (min) | $32,532 |
| Home equity interest limit | $752,000 |
| Personal needs allowance | $70/month |
North Carolina also has a 60-month look-back period. Medicaid checks past asset transfers before approving long-term care benefits.
For details on how Medicaid pays providers, see our Medicaid fee schedule in the 2026 guide.
How to Qualify if You Are Over the Income Limit
Being slightly over the limit does not always mean denial. North Carolina offers a few options.
Medically Needy (Spend-Down) Program
This program helps people with high medical bills. The income limit is $242 per month for a single person. You “spend down” excess income on medical costs over six months. Once your bills reach the required amount, you qualify.
Deductions and Household Changes
NC Medicaid reviews each case individually. Job loss, reduced hours, or adding a dependent can change your eligibility. The state encourages everyone to apply, even if close to the limit.
How to Apply for NC Medicaid in 2026
Applying is free and simple. You can choose from several methods.
- Online: Visit epass.nc.gov or HealthCare.gov
- Phone: Call 1-888-245-0179 (Monday–Friday, 8 AM–5 PM)
- In person: Go to your local County DSS office
- Mail: Send your application to P.O. Box 24309, Raleigh, NC 27611
Processing takes about 45 days. Disability cases may take up to 90 days. Benefits can go back 3 months if you were eligible.
Need free help? The NC Navigator Consortium offers free appointments. Call 1-855-733-3711 or visit ncnavigator.net.
Who Qualifies for NC Medicaid in 2026?
Here is a quick look at each group and its FPL percentage.
| Group | FPL Percentage | Asset Test? |
|---|---|---|
| Adults 19–64 | 138% | No |
| Children 0–18 | 216% | No |
| Pregnant women | 201% | No |
| Parents with dependents | 45% | No |
| Seniors 65+ | 100% FBR | Yes |
| Disabled adults | 100% FBR | Yes |
| Family planning | 195% | No |
Working adults can qualify. Part-time workers can qualify. Gig workers can qualify. Employment does not disqualify you.
Frequently Asked Questions
1. What is the NC Medicaid income limit for a single person in 2026?
A single adult ages 19–64 can earn up to $1,800/month to qualify for NC Medicaid Expansion as of February 2026. This is based on 138% of the 2025 FPL. The limit is expected to rise to ~$1,835/month on April 1, 2026.
2. Does NC Medicaid have an asset test in 2026?
NC Medicaid Expansion (adults 19–64) has no asset test. Savings don’t count. However, Traditional Medicaid for aged, blind, and disabled individuals does have an asset limit of $2,000 for a single person.
3. When do the new 2026 NC Medicaid income limits take effect?
The 2026 Federal Poverty Guidelines were released in January 2026. NC Medicaid is expected to adopt the new, slightly higher limits on April 1, 2026 — roughly a 2% increase from today’s figures.
4. Can pregnant women qualify for Medicaid if their income is too high for regular Medicaid?
Yes. Pregnant women qualify under a higher limit — up to 196% FPL, or $2,557/month for a single woman. Coverage includes prenatal care, delivery, and 12 months of postpartum care.
5. What is the NC Medicaid income limit for a family of 4 in 2026?
A household of four qualifies for NC Medicaid Expansion with income up to $3,697/month. For children in that home, the limit is even higher — up to $5,654/month — under NC’s children’s Medicaid program.
6. How do I apply for NC Medicaid in 2026?
Apply online at epass.nc.gov, call 1-888-245-0179, or visit your local DSS office. You’ll need proof of income, identity, and NC residency. Most applications are processed within 45 days.
Sources: NC DHHS Medicaid Eligibility Page | HealthCare.gov | North Carolina Department of Health and Human Services. All figures reflect 2026 Federal Poverty Level guidelines and are current until April 1, 2026.
