NC Medicaid Changes: Everything You Need to Know

Upcoming federal changes to NC Medicaid may affect your coverage.

Beginning Oct. 1, 2026, new requirements apply to Medicaid recipients, including changes to coverage for non-citizens, a work requirement for people covered by Medicaid expansion, and a shorter coverage period for medical costs paid retroactively. There will also be twice-a-year renewals instead of once a year.

This is why it's important for everyone who has NC Medicaid to do these 3 things:

Upcoming Changes

Starting October 1, 2026 – Non-U.S. Citizens

Many people who are not U.S. citizens will lose their Medicaid.

You may be able to get or keep your Medicaid if:

• You are a lawful permanent resident (you have a green card). Most green card holders must also wait 5 years.
• You are a child under age 19 who is lawfully residing in the U.S.
• You are pregnant, recently pregnant, or gave birth in the last 12 months and are lawfully residing in the U.S.
• You have Cuban or Haitian entrant status.
• You are a citizen of Micronesia, the Marshall Islands or Palau living in the U.S.

If your situation is not listed here, you might lose your Medicaid starting October 1, 2026.

Learn more about this new rule on the N.C. Department of Health and Human Services website.

Starting January 1, 2027 – Work Requirement for Ages 19 through 64

Medicaid will require you to work, go to school, or volunteer 80 hours a month. You can also meet the requirement if your household earns at least $580 a month.

You must show proof of the time you worked and the money you made, including pay stubs, school attendance records, volunteer hour records, etc.

Some people do not need to meet this rule. These include people with a disability, parents of children under age 14, people who are pregnant and others.

Learn more about this new work requirement on the NCDHHS website.

Starting January 1, 2027 – Six-Month Renewals

Medicaid renewals are also changing. Starting Jan. 1, 2027, most adults ages 19 through 64 will renew their Medicaid every six months instead of once per year. When it is time for people to renew, BCHHS will mail you a letter if we need additional information.

Starting January 1, 2027 – Shorter Retroactive Coverage

If you do not have Medicaid and are applying for it, or reapplying, Medicaid can pay for some of the care you receive before you submit your application. This is called “retroactive coverage.” The period Medicaid will cover is getting shorter.

• Most adults ages 19 through 64 who do not have a disability: Medicaid will cover up to 1 month of health care costs incurred before you submit your application.
• Children, adults 65 and older, and people with a disability: Medicaid will cover up to 2 months of health care costs incurred before you submit your application.

If you apply by December 31, 2026, Medicaid will cover approved costs for up to 3 months before you applied.

If you lose your Medicaid

You will get a letter. It will explain why, and it will tell you how to appeal if you disagree. You usually have 60 days from the date on the letter. How to appeal a Medicaid decision.

For free help with a notice or a bill, call the NC Medicaid Ombudsman at 1-877-201-3750. The Ombudsman is independent of your local Department of Social Services (DSS).

These organizations may also be able to help:

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