The monthly income limit for Medicaid in North Carolina is roughly $1,800 for a single adult under the state’s expansion program, which covers people ages 19 through 64 at or below 138% of the federal poverty level.1NC Medicaid. NC Medicaid Eligibility Pregnant women, children, and adults who qualify based on age or disability each have different cutoffs, some higher and some lower. The dollar figures below are current through March 31, 2026, and will update when North Carolina incorporates the new federal poverty guidelines on April 1, 2026.
Income Limits by Eligibility Group
North Carolina sets each group’s limit as a percentage of the federal poverty level (FPL). The 2026 FPL for a single person in the contiguous United States is $15,960 per year, or $1,330 per month.2ASPE. 2026 Poverty Guidelines The percentages below are applied to those figures.
Expansion Adults: 138% FPL
Adults ages 19 through 64 qualify under Medicaid expansion based on income alone. You do not need to have children, a disability, or any other qualifying condition. The monthly gross-income caps are:1NC Medicaid. NC Medicaid Eligibility
- Family of 1: $1,800
- Family of 2: $2,433
- Family of 3: $3,065
- Family of 4: $3,698
- Family of 5: $4,340
North Carolina began covering this group on December 1, 2023.3NC Medicaid. North Carolina Expands Medicaid These figures are gross income, before taxes.
Pregnant Women: 196% FPL
Pregnant women qualify at a higher threshold, 196% of FPL. When the state calculates household size, the unborn child counts as a family member, so a single pregnant woman is treated as a family of two.4North Carolina Department of Health and Human Services. Basic Medicaid Eligibility Requirements Under that rule, a single pregnant woman can earn up to $3,339 per month and still qualify. A pregnant woman in a household of three (counting the unborn child) can earn up to $4,218.
Children: Up to 211% FPL
Children from birth through age 18 qualify under the Medicaid Infant/Children program at income levels up to 211% of FPL, one of the more generous thresholds in the state’s system.5North Carolina Department of Health and Human Services. Change Notice for Manual No. 03-23 – Federal Poverty Level Updates The former NC Health Choice program was folded into Medicaid in 2023, so children’s coverage now runs through a single application. The exact dollar cap depends on total household size.
Aged, Blind, and Disabled
Adults 65 and older, people who are blind by Social Security standards, and people who meet Social Security’s disability criteria fall under a different calculation with lower caps. For a single person, the monthly income limit is $1,305; for a couple, it is $1,763.6North Carolina Department of Health and Human Services. MA-2252 Non-MAGI Medicaid Income/Reserve Limits This group also faces an asset test that the other categories do not: $2,000 for a single person, $3,000 for a couple. Countable assets include bank accounts and certain investments, but generally not your primary home, one vehicle, or personal belongings.
People already receiving Supplemental Security Income (SSI) automatically qualify for Medicaid and do not file a separate application.4North Carolina Department of Health and Human Services. Basic Medicaid Eligibility Requirements
Parents and Caretaker Relatives
Adults who live with and care for a related child under 18 can also qualify under a dedicated category.7North Carolina Department of Health and Human Services. Family and Children’s Medicaid Manual MA-3235 Caretaker Relatives/Kinship Most adults in this situation will now compare their income against the 138% expansion limit as well, since whichever pathway fits best will be used.
How North Carolina Counts Your Income
Not every dollar you receive counts toward the limit. For expansion adults, children, pregnant women, and parents or caretaker relatives, the state uses the Modified Adjusted Gross Income (MAGI) method, which follows federal tax rules.8North Carolina Department of Health and Human Services. MA-3306 Modified Adjusted Gross Income (MAGI) Under MAGI, countable income includes wages, self-employment earnings after business expenses, and Social Security benefits.
Several sources are specifically excluded. Child support, veterans’ benefits, gifts, inheritances, and contributions to employer-sponsored retirement plans like a 401(k) do not count.9NC Department of Health and Human Services. MAGI Household Composition and Income Determination SSI is also excluded. Because of these exclusions, your countable income for Medicaid can be noticeably lower than what you consider your household’s total income.
If you qualify based on age, blindness, or disability, the state uses non-MAGI rules instead. That calculation looks at a broader range of income sources, including retirement distributions and investment returns, and applies its own deductions and disregards. It also includes the asset test described above, so applications in this category require more detailed financial documentation.6North Carolina Department of Health and Human Services. MA-2252 Non-MAGI Medicaid Income/Reserve Limits
What If Your Income Is Over the Limit?
You may still qualify through the Medically Needy pathway if you have significant medical expenses. The monthly income threshold for this program is much lower: $242 for a single person and $317 for a couple.4North Carolina Department of Health and Human Services. Basic Medicaid Eligibility Requirements The gap between your countable income and that figure becomes your “deductible,” the amount of medical expenses you must accumulate before Medicaid starts paying.
The deductible is calculated over a six-month period.10NCDHHS Policies. MA-2120 Medically Needy Regulations If your countable income is $1,000 a month and the Medically Needy limit is $242, your monthly excess is $758. Multiplied by six, that produces a deductible of $4,548. Once your qualifying medical bills during that six-month window reach that total, Medicaid covers you for the rest of the period. A $3,000 resource (asset) limit also applies.
Retroactive Coverage for Past Medical Bills
If you had medical expenses in the months before you applied, you can ask for retroactive Medicaid coverage for up to three months before your application month.11NC Medicaid. NC Medicaid Expansion Questions and Answers If you apply in March and are approved, Medicaid can pay for covered services from the previous December, January, and February, provided you met the income rules in those months as well. This matters if you delayed applying while dealing with a sudden hospitalization or a surprise bill.
When the Limits Change
North Carolina updates these dollar amounts once a year on April 1, when the state incorporates the new federal poverty guidelines issued by the U.S. Department of Health and Human Services.1NC Medicaid. NC Medicaid Eligibility The percentages (138%, 196%, 211%) stay the same from year to year; the dollar figures tied to them shift because the underlying FPL shifts. If you are checking your eligibility close to that date, confirm whether the number you are using reflects the current year’s guideline.