Since December 2023, NC Medicaid covers adults 19–64 with income up to 138% of the federal poverty level, including people without kids and people who work. It covers doctor visits, prescriptions, mental health and substance use care, and more, usually at little or no cost.
County next steps
Orange · Durham · Wake · North Carolina · Adults 18+
Orange County
Orange County DSS
113 Mayo Street, Hillsborough; or 2501 Homestead Road, Chapel Hill
919-245-2800- Ask about adult Medicaid, Food and Nutrition Services, energy assistance, or another benefit you need.
- Confirm application options, required documents, interview arrangements, and any emergency processing.
- Use ePASS where available, keep confirmation, and agree on the next follow-up. Eligibility is assessed by the program.
Official source checked November 4, 2026. Confirm current hours, eligibility, costs, and availability directly.
Durham County
Durham County DSS
414 East Main Street, Durham, NC 27701
919-560-8000- Ask about adult Medicaid, Food and Nutrition Services, energy assistance, or another benefit you need.
- Confirm application options, required documents, interview arrangements, and any emergency processing.
- Use ePASS where available, keep confirmation, and agree on the next follow-up. Eligibility is assessed by the program.
Official source checked November 4, 2026. Confirm current hours, eligibility, costs, and availability directly.
Wake County
Wake Health & Human Services — Swinburne
220 Swinburne Street, Raleigh, NC 27610
919-212-7000- Ask about adult Medicaid, Food and Nutrition Services, energy assistance, or another benefit you need.
- Confirm application options, required documents, interview arrangements, and any emergency processing.
- Use ePASS where available, keep confirmation, and agree on the next follow-up. Eligibility is assessed by the program.
Official source checked November 4, 2026. Confirm current hours, eligibility, costs, and availability directly.
Orange County
Orange County medical clinics
300 West Tryon Street, Hillsborough; or 2501 Homestead Road, Chapel Hill
919-245-2400- Ask which clinic offers the adult service needed and whether an appointment is required.
- Confirm insurance, uninsured options, charges, hours, and any testing or pharmacy arrangements.
- For behavioral-health treatment, use the adult local directory or ask a clinician for an in-county referral.
Official source checked November 4, 2026. Confirm current hours, eligibility, costs, and availability directly.
Durham County
Durham County Public Health
414 East Main Street, Durham, NC 27701
- Use the county’s official public-health information to locate the adult clinic or service needed.
- Confirm appointment requirements, testing options, charges, and insurance before traveling.
- For substance-use care, use the adult local directory and confirm assessment and medication access with the provider.
Official source checked November 4, 2026. Confirm current hours, eligibility, costs, and availability directly.
Wake County
Wake County adult clinic & pharmacy navigation
Public Health Pharmacy: 200 Swinburne Street, #1203, Raleigh, NC 27610
919-250-4418- Use Wake’s official health-clinic information to identify the needed adult service; the listed phone is for the pharmacy, not general treatment intake.
- Ask about the specific service’s appointment, payment, and eligibility rules.
- For substance-use care, use an in-county adult provider and confirm intake directly.
Official source checked November 4, 2026. Confirm current hours, eligibility, costs, and availability directly.
Key facts
- Apply online at ePASS, at the county DSS office, by phone, or through HealthCare.gov.
- Most people are in a Standard Plan (health plan). People with serious mental illness, serious substance use disorders, I/DD, or TBI may qualify for a Tailored Plan run by the LME/MCOs.
- Medicaid Direct (NC Medicaid Direct) covers people not in a plan, and some can choose it.
- Medicaid renewal happens every year. A renewal letter or form comes in the mail. Update the address with DSS.
- Free rides to medical appointments (Non-Emergency Medical Transportation) come through the county DSS or the health plan.
- If Medicaid is denied or cut off, people can ask for a fair hearing. To keep coverage during the appeal, ask before the change date.
- Medicaid may pay medical bills from up to 3 months before the application (retroactive coverage). Ask about it.
Who qualifies
- Adults 19–64 with income at or below 138% of the federal poverty level
- Other adult categories include pregnant people, parents, people 65+, people who are blind or disabled, and eligible adults formerly in foster care up to age 26
- Must be an NC resident and a US citizen or qualified non-citizen (emergency Medicaid has different rules)
What to bring (checklist)
Common mistakes to avoid
- Assuming they don't qualify because they work.
- Missing the renewal form.
- Not reporting a new address.
Official sources
- NC Medicaid
- NC Medicaid Expansion
- ePASS application
- NC Medicaid Tailored Plans
- NC Medicaid Ombudsman
- Find your county DSS
Last checked October 2026. Amounts and rules change, so confirm with the official source before sharing.