North Carolina Medicaid Income Limits

Updated August 2026

NC Medicaid uses different income thresholds depending on who is applying. MAGI-based programs (most working-age adults, children, and pregnant women) use a modified adjusted gross income calculation aligned with federal tax rules. Non-MAGI programs — primarily for seniors and people with disabilities — use different financial rules and include an asset test.

138% FPL

Adults 19–64 (expanded)

196% FPL

Pregnant women

211% FPL

Children (0–18)

$0 premium

No monthly premium

NC Medicaid expanded in December 2023

North Carolina expanded Medicaid eligibility on December 1, 2023, extending coverage to adults ages 19–64 who earn up to 138% of the Federal Poverty Level. If you were previously denied because of income, you may qualify now. Apply at epass.nc.gov.

Income limits by coverage group

Dollar figures below are based on the NC Medicaid eligibility guide published by NCDHHS, current through April 1, 2026. FPL amounts are adjusted each year — verify current thresholds at medicaid.ncdhhs.gov/eligibility.

Coverage group	Income limit (% FPL)	Approx. monthly limit (1 person)	Asset test?
Adults 19–64 (ACA expansion)	138% FPL	~$1,835/mo	No
Children ages 0–18 (NC Medicaid / NC Health Choice)	Up to 211% FPL	~$2,807/mo	No
Pregnant women (counts unborn child in household size)	Up to 196% FPL	~$3,535/mo	No
Adults 65+ — full Medicaid	100% FPL	~$1,330/mo	Yes — $2,000 individual
Adults 65+ — other Medicaid programs (e.g., Medicare Savings)	Up to 135% FPL	~$1,796/mo	Yes — $2,000 individual
Nursing facility / long-term care	Varies by program	Contact DSS	Yes — $2,000 individual

Adults 19–64 (ACA expansion)

Income limit (% FPL): 138% FPL
Approx. monthly limit (1 person): ~$1,835/mo
Asset test?: No

Children ages 0–18 (NC Medicaid / NC Health Choice)

Income limit (% FPL): Up to 211% FPL
Approx. monthly limit (1 person): ~$2,807/mo
Asset test?: No

Pregnant women (counts unborn child in household size)

Income limit (% FPL): Up to 196% FPL
Approx. monthly limit (1 person): ~$3,535/mo
Asset test?: No

Adults 65+ — full Medicaid

Income limit (% FPL): 100% FPL
Approx. monthly limit (1 person): ~$1,330/mo
Asset test?: Yes — $2,000 individual

Adults 65+ — other Medicaid programs (e.g., Medicare Savings)

Income limit (% FPL): Up to 135% FPL
Approx. monthly limit (1 person): ~$1,796/mo
Asset test?: Yes — $2,000 individual

Nursing facility / long-term care

Income limit (% FPL): Varies by program
Approx. monthly limit (1 person): Contact DSS
Asset test?: Yes — $2,000 individual

Family size and the 138% FPL threshold

Per NCDHHS figures, a single adult qualifies for expansion Medicaid at roughly $1,835 per month in gross income. A family of three qualifies at roughly $3,141 per month. These figures track the 2026 federal poverty guidelines and are adjusted each year. The income counted is gross household income — before taxes, before most deductions.

One counterintuitive fact: some types of income are excluded from MAGI calculations under IRS rules. Child support received, certain veterans' benefits, and workers' compensation are examples. If your gross pay looks too high but you receive income that may be excluded, don't assume you're ineligible before applying — ePASS will calculate your MAGI automatically.

No monthly premium — and a $4 copay cap

NC Medicaid charges no monthly premium for any enrollee group, including the newly expanded adults and children covered through NC Health Choice. Copays exist for some services but are capped at $4 per service. Emergency services and preventive care are typically copay-free.

NC Health Choice — the CHIP-funded portion of children's coverage for families whose income is too high for standard NC Medicaid but at or below roughly 211% FPL — is billed and administered alongside NC Medicaid, so most families simply apply once through ePASS and are placed in whichever program fits their income.

Asset rules — MAGI vs. non-MAGI programs

The ACA expansion, children's programs, and pregnancy coverage use MAGI rules, which means no asset test. Your savings, car, or home value do not count against you. This is different from older Medicaid programs for seniors and people with disabilities, which were built before MAGI existed and still apply resource limits.

For nursing facility Medicaid and long-term care programs, the asset limit is $2,000 for a single individual. A home (under certain conditions), one vehicle, and personal property are exempt from this count. Married couples are subject to spousal impoverishment protections under federal law, which allow the community spouse to retain a portion of the couple's assets — see the seniors and long-term care page for detail.

138% FPL income limit by household size (2026)

The table below shows the approximate monthly and annual gross income limits for adult NC Medicaid eligibility (138% FPL) based on 2026 HHS federal poverty guidelines as reported by NCDHHS.

Household size	Monthly limit (138% FPL)	Annual equivalent
1 person	~$1,835/mo	~$22,020/yr
2 people	~$2,489/mo	~$29,868/yr
3 people	~$3,141/mo	~$37,692/yr
4 people	~$3,795/mo	~$45,540/yr
5 people	~$4,449/mo	~$53,388/yr
6 people	~$5,101/mo	~$61,212/yr
7 people	~$5,755/mo	~$69,060/yr
8 people	~$6,408/mo	~$76,896/yr

1 person

Monthly limit (138% FPL): ~$1,835/mo
Annual equivalent: ~$22,020/yr

2 people

Monthly limit (138% FPL): ~$2,489/mo
Annual equivalent: ~$29,868/yr

3 people

Monthly limit (138% FPL): ~$3,141/mo
Annual equivalent: ~$37,692/yr

4 people

Monthly limit (138% FPL): ~$3,795/mo
Annual equivalent: ~$45,540/yr

5 people

Monthly limit (138% FPL): ~$4,449/mo
Annual equivalent: ~$53,388/yr

6 people

Monthly limit (138% FPL): ~$5,101/mo
Annual equivalent: ~$61,212/yr

7 people

Monthly limit (138% FPL): ~$5,755/mo
Annual equivalent: ~$69,060/yr

8 people

Monthly limit (138% FPL): ~$6,408/mo
Annual equivalent: ~$76,896/yr

What counts as income for NC Medicaid (MAGI rules)

Wages, salaries, and tips
Self-employment net income
Unemployment compensation
Social Security benefits (taxable portion)
Rental income (net of expenses)
Taxable interest and dividends
Alimony received (pre-2019 agreements)

What does not count as income for NC Medicaid (MAGI rules)

If your gross income looks too high but you receive income that may be excluded from MAGI, apply anyway — ePASS calculates your MAGI automatically and may find you eligible. Self-employment income is counted as net earnings after allowable business expenses.

Child support received
Veterans' benefits (most types)
Workers' compensation
SNAP, TANF, and most public benefits
Gifts and inheritances
SSI payments
Tax-exempt interest

Medicare Savings Programs (QMB) in North Carolina

Search interest in "North Carolina QMB income limits" reflects real confusion: QMB is only one of three Medicare Savings Programs North Carolina runs through NC Medicaid for residents who are also enrolled in Medicare. The other two — SLMB and Qualifying Individual (QI) — cover less but reach further up the income scale.

Program	Situation	Monthly income limit
QMB	Individual	$1,350/mo
QMB	Married couple	$1,824/mo
SLMB	Individual	$1,616/mo
SLMB	Married couple	$2,184/mo
QI	Individual	$1,816/mo
QI	Married couple	$2,455/mo

QMB

Situation: Individual
Monthly income limit: $1,350/mo

QMB

Situation: Married couple
Monthly income limit: $1,824/mo

SLMB

Situation: Individual
Monthly income limit: $1,616/mo

SLMB

Situation: Married couple
Monthly income limit: $2,184/mo

QI

Situation: Individual
Monthly income limit: $1,816/mo

QI

Situation: Married couple
Monthly income limit: $2,455/mo

Qualified Medicare Beneficiary (QMB) is the most valuable tier. North Carolina sets the 2026 QMB limit at $1,350/mo for an individual and $1,824/mo for a married couple, with resource limits of $9,950 and $14,910 respectively. QMB pays the Part A premium if one is owed, the full Part B premium ($202.90/mo in 2026), and all Medicare deductibles, coinsurance, and copayments — and under federal law, no provider may bill a QMB enrollee for that cost-sharing, no exceptions.

SLMB reaches individuals earning up to $1,616/mo ($2,184/mo for couples) and QI reaches up to $1,816/mo ($2,455/mo for couples); both use the same resource limits as QMB but pay only the Part B premium. QI is funded on a capped, first-come first-served basis each year, so QI recipients must reapply annually rather than renewing automatically.

Enrollment in any tier triggers automatic Extra Help, which caps what you pay for covered Part D drugs at $12.65 each in 2026. Apply for a Medicare Savings Program through your county Department of Social Services — the same office that decides NC Medicaid eligibility for every other program on this page — or call the NC Medicaid Contact Center at 1-888-245-0179. If your county DSS is slow to respond, the NC Medicaid Ombudsman at 1-877-201-3750 can help you navigate the process.

NC Medicaid

Visit the official North Carolina Medicaid website

Income Limits in Nearby States

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