Skip all navigation Skip to page navigation

DHHS Home | A-Z Site Map | Get Updates | Divisions | About Us | Contacts | En Español

NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 
NC Division of Medical Assistance - High quality health care through Medicaid and Health Choice for Children.

Who is Eligible - Infants, Children, & Families

"The Partnership for a Healthy NC" (Medicaid Reform)

Click here to learn more about Medicaid Reform

Medicaid serves infants, children, and families in several ways:

When determining eligibility, Modified Adjusted Gross Income (MAGI) methodology is used to determine how income is counted and how household composition and a family size is constructed.  MAGI is the adjusted gross income, with specific exceptions, of a tax filer according to federal tax rules. MAGI-based income determines if you and/or your children qualify.  Your county worker will calculate your monthly family income.

Medicaid for Infants and Children

Medicaid for Infants and Children (MIC) provides medical coverage for children under age 19. The income limits are determined by the family size and the age of the child(ren) for whom you are applying.

There is no limit on resources.

Your monthly countable income cannot be more than the amounts listed below.

Monthly Income Limits: Medicaid for Infants and Children
(Effective April 2014)
Family Size Age
0 - 5
Age
6 – 18
1 $2,043 $1,294
2 $2,753 $1,744
3 $3,464 $2,194
4 $4,174 $2,644
5 $4,885 $3,094

If your family income is greater than the amounts listed above, your child(ren) age 6-18 may be eligible for NC Health Choice for Children or Medicaid with a Medicaid deductible.

Medicaid for Families with Dependent Children 

Medicaid for Families with Dependent Children provides medical coverage for parent(s) or other caretaker/relative with child(ren) age 18 and under in the household and for children under age 21. A pregnant woman may also qualify.

Your monthly countable income cannot be more than the amounts listed below.

Monthly Income Limits: Medicaid For Families with Dependent Children
(Effective April 2014)
Family Size Caretakers and Children age 19 and 20
1 $434
2 $569
3 $667
4 $744

You cannot have more than $3,000 in assets such as savings in the bank.

If the family income is over the limit and your child(ren) and/or family have high medical bills, you may still qualify for Medicaid and have a Medicaid deductible.

Medicaid for Pregnant Women

Medicaid for Pregnant Women only covers services related to pregnancy:

  • Prenatal care, delivery and 60 days postpartum care
  • Services to treat medical conditions which may complicate the pregnancy (some services require prior approval)
  • Childbirth classes
  • Family planning services

A pregnant woman may apply for this program before or after she delivers. A woman who has experienced a recent pregnancy loss may also be eligible.

The monthly family income cannot exceed 196% of the federal poverty level. There is no limit on resources. If a pregnant woman is covered by Medicaid on the date she delivers, her newborn child may be eligible for Medicaid up to age 1 without a separate application.

Your monthly countable income cannot be more than the amounts listed below.

Monthly Family Income Limits: Medicaid for Pregnant Women
(Effective April 2014)
Family Size Monthly Income Limit
2 $2,570
3 $3,233
4 $3,896
(An unborn child is always counted in the family size.)

If you think you may be eligible, see "How to Apply."

Learn more through the "Consumer Guide: Health Insurance Program for Families and Children" (PDF, 849KB)

 

State of North Carolina Home Page