Apply for Medicaid or Health Choice

Apply Online Now

There are three ways to apply (one application works for Medicaid and Health Choice).

  1. Apply online at ePass.
  2. Apply in person at your county Division of Social Services (DSS) office. It helps to fill out as much of the application as possible ahead of time.
  3. Fill out a paper application and mail to or drop it off at your county DSS office.

Call your county DSS office if one of these methods will not work for you.

Watch this video to learn about applying online through ePass.

Gather These Items before You Apply

You’ll need your NCID. “NCID” is a secure online user ID and password set up by you to control access to many North Carolina government agencies, including Medicaid.

You’ll also need:

  • Certified birth certificates or other proof of citizenship/alien status
  • Identity documents
  • Social Security cards, Social Security numbers or proof that you have made an application for a number from the Social Security Office
  • Two pieces of documentation to verify that you live in North Carolina
  • Copies of all pay stubs for last month
  • Copies of all medical or life insurance policies
  • List of all cars, trucks, motorcycles, boats, etc. that you or anyone in your household own, including the year, make, model and vehicle identification number (VIN) for each item
  • Most recent bank statements
  • List of all real property you own
  • Current financial statements/award letters from other sources of income, such as Social Security, retirement benefits, pensions, veteran benefits and child support

Medicaid and Health Choice Applications

Program Applications
Application for Health Coverage & Help Paying Costs DMA-5200
Application for Health Coverage & Help Paying Costs (Short Form) DMA-5201
Health Coverage from Jobs - Appendix A DMA-5202-A
American Indian or Alaska Native Family Member (AI/AN) - Appendix B DMA-5202-B
Designation of Authorized Representative - Appendix C DMA-5202-C
Income/Resources - Appendix D DMA-5202-D
Medical Bills - Appendix E DMA-5202-E

Aplicacións en Espanol

Programa Aplicación
Solicitud Para Cobertura de Salud y Ayuda Para Pagar los Costos DMA-5200sp
Apéndice A - Coberta de salud de empleos DMA-5202-Asp
Apéndice B - Miembro de la familia amerindio o nativo de Alaska (AI/AN) DMA-5202-Bsp
Apéndice C - Designación de representante autorizado DMA-5202-Csp
Apéndice E - Facturas médicas DMA-5202-Esp
Apéndice F - Ingresos/Recursos DMA-5202-Fsp

Contact

Medical Assistance Operations Section
Phone: 919-855-4050
Fax: 919-715-8548