North Carolina CHIP: Children's Health Insurance Program
Updated August 2026
North Carolina's former Children's Health Insurance Program, NC Health Choice, merged into NC Medicaid on April 1, 2023, following a provision in the state's July 2022 budget — NCDHHS reports North Carolina joined 17 other states that have combined their Medicaid and CHIP programs for children. About 55,000 children moved from NC Health Choice to NC Medicaid automatically, keeping the same Medicaid ID number and, in nearly all cases, the same providers.
Merged into Medicaid
NC Health Choice ended April 1, 2023 — CHIP-eligible children now get NC Medicaid
~211% FPL
NC Medicaid income limit for children ages 0–18 (family of 4)
$0
Premiums and copays for NC Medicaid members under age 21
NC Health Choice no longer exists as a separate program
Effective April 1, 2023, North Carolina moved all children with NC Health Choice coverage into NC Medicaid, per NCDHHS. The move was automatic — no action was required from families. Children who previously had NC Health Choice kept their same provider network in most cases, gained access to Non-Emergency Medical Transportation (NEMT) and full EPSDT benefits, and no longer pay enrollment fees or copays. NC now covers all eligible children ages 0–18 under one program instead of splitting coverage by age.
What happened to NC Health Choice?
CHIP dollars (Title XXI funding) still help finance coverage for children in the income band NC Health Choice used to serve, but that coverage is now delivered and branded entirely as NC Medicaid — there is no separately named CHIP plan, card, or application in North Carolina today.
Who qualifies for NC Medicaid as a child
NC Medicaid now covers children ages 0 through 18 under a single set of income limits — there is no longer a separate age-6 cutoff between "Medicaid" and "Health Choice" eligibility. Per NCDHHS's current eligibility guidance, a child ages 0 through 18 in a family of 4 may qualify with family income up to $5,803 per month (about 211% FPL); limits are higher for smaller households and lower for larger ones, scaled by family size.
- Child must be a NC resident
- Age 0 through 18 (EPSDT benefits continue through age 20)
- Family income at or below the current NC Medicaid limit for the family's size (roughly 211% FPL for a family of 4)
- U.S. citizen or eligible immigration status — families that include non-citizens can still apply for an eligible child
- Have a Social Security number, or show that you've applied for one
What NC Medicaid covers for children
Children who moved from NC Health Choice to NC Medicaid gained benefits that weren't previously covered, including Non-Emergency Medical Transportation (NEMT) to and from medical appointments and full Early and Periodic Screening, Diagnostic and Treatment (EPSDT) coverage. Benefits are delivered through NC Medicaid Managed Care Standard Plans.
- Routine well-child visits and preventive care
- Doctor and specialist visits
- Hospital care — inpatient and outpatient
- Prescription medications — brand-name and generic
- Dental care — exams, cleanings, fillings, and extractions
- Vision care — eye exams and eyeglasses
- Mental health and substance use services
- Emergency room and urgent care visits
- Physical, occupational, and speech therapy when medically necessary
- Non-Emergency Medical Transportation (NEMT) to covered appointments
- EPSDT mandate for children under 21 — all medically necessary services must be covered
Premiums and cost sharing
NC Medicaid is low- or no-cost, per NCDHHS: there are no monthly premiums, and the standard copay of up to $4 per visit or prescription does not apply to members under age 21. Families formerly on NC Health Choice no longer pay the enrollment fees or copays that program used to charge.
How to apply for NC Medicaid
Apply through ePASS at epass.nc.gov — on the application, NC Medicaid is listed as "Medical Assistance." You'll need an NCID (a secure North Carolina government login) to apply online.
Applications are also accepted in person or by phone at your local county Department of Social Services (DSS), or by calling the NC Medicaid Contact Center at 1-888-245-0179. You can apply at any time of year, and coverage has no separate age-based application path anymore — one application and one set of income limits covers all children ages 0–18.
If approved, you'll choose a Standard Plan health plan for the child. NC's enrollment broker — reachable at ncmedicaidplans.gov or 1-833-870-5500 — can help compare plans based on the child's current doctors and any preferred pharmacy.
What CHIP is
CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for standard Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Some states, including North Carolina since 2023, use their CHIP funding to expand Medicaid itself rather than operate a separately branded CHIP program — commonly called Medicaid-expansion CHIP, or M-CHIP.
CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families. Nationally, CHIP covers approximately 7 million children, according to CMS data.
NC Medicaid
- ePASS application portal: epass.nc.gov
- NC Medicaid Contact Center phone line: 1-888-245-0179
- NC Medicaid enrollment broker: ncmedicaidplans.gov / 1-833-870-5500
- NC Medicaid website: medicaid.ncdhhs.gov
- NC Health Choice Move to Medicaid information: medicaid.ncdhhs.gov/nc-health-choice-move-medicaid
Related guides
For Pregnant Women
Coverage, income rules, and postpartum benefits during pregnancy.
Read more →Eligibility Requirements
The income, household, age, and state rules that determine who qualifies.
Read more →What Medicaid Covers
The services every state must cover, plus benefits that vary by state.
Read more →