Medicaid planning in North Carolina can be stressful and anxiety-inducing. There are innumerable guidelines to follow, countless documents to obtain, and multiple appointments to make. Plodding through the intricate and time-consuming application process is enough to make you throw up your hands in defeat.

It doesn't have to be this way!

At Senior Planning Services, we are thoroughly familiar with the Medicaid requirements in NC for seniors. So you don’t have to undergo the stress and anxiety that often comes along with applying to Medicaid, our North Carolina Medicaid specialists take care of the entire application and approval process for you. You get more than sound advice when you work with us; you get actual execution and implementation.

Seniors and their families need access to the Medicaid benefits they deserve. Our comprehensive services are aimed at meeting this need. We streamline the entire Medicaid process, starting with an initial consultation and assessment. Next, we assist with obtaining Medicaid-required documentation and paperwork, fill out applications on your behalf, and act as a liaison with the State of North Carolina's Medicaid eligibility department. We'll be right by your side until you receive your official approval.
Ready to apply for Medicaid in NC? We can help!
Contact Senior Planning Services today to learn more
request your free
no-obligation consultation
Asset allowances document checklist

What Is Medicaid and Why Do I Need It?

Medicaid is a safety net. One of its primary purposes is to fund the costs of nursing facilities and assisted living facilities. The average cost of assisted living in North Carolina is $9,000 per month, or $108,000 per year, a steep sum even for those who have been saving for this. If you qualify, North Carolina long-term care Medicaid can help offset these costs, ensuring you receive a high level of care even if your savings can't pay for it all.

What Determines Medicaid Eligibility in NC?

Long-term care Medicaid eligibility in North Carolina depends on several factors. Though the Medicaid program is designed to help people pay for the often staggering costs of nursing homes and other long-term care options, there's a caveat. You must adhere to numerous rules and regulations to receive benefits.

To meet eligibility standards for Medicaid nursing homes in North Carolina, you must:
• Be a legal U.S. citizen or qualified alien
• Be a resident of North Carolina
• Meet income and asset requirements
• Be 65 years of age, blind, or permanently disabled

Financial Requirements

Income

Income

North Carolina Medicaid for seniors is dependent on the level of income an applicant has. The applicant's monthly income is paid directly to the facility. Medicaid for the Aged (MAA) will supplement the remaining balance of the facility costs after the PPA (Patient Paid Amount) or income payment is applied to the account. North Carolina Medicaid eligibility standards allow certain deductions to be made from the applicant's income, including:
1. Secondary Insurance Premiums
2. PNA (Personal Needs Allowance): The applicant may retain $70.00 per month for personal expenses.
In specific cases, a spouse may be permitted to keep a portion of the applicant's income, depending on the individual circumstances.
Assets

Assets

Medicaid eligibility in NC also depends on an individual’s assets. A long-term care applicant's assets must fall below specific thresholds to qualify for Medicaid. As of 2025, the asset limits in North Carolina are $2,000 for single applicants, $3,000 for couples applying together, and up to $157,920 for the non-applicant spouse in cases where only one spouse is applying.

It’s important to note that Medicaid enforces a five-year look-back period for financial transactions. During this time, any gifts or asset transfers may result in a penalty period of ineligibility for Medicaid coverage. This penalty corresponds to the total value of assets gifted or transferred during the look-back period. (There are some exceptions to the transfer rules that Medicaid may allow.)
Medical

Medical

A pre-admission screening (PAS) is required to determine the applicant's medical eligibility. A physical evaluation from a Medicaid nurse will ascertain whether you need assistance with activities of daily living (ADL), such as showering, dressing, eating, and toileting.

Why You Will Gain By Using Our Medicaid Specialists

In a word: expertise.
At Senior Planning Services, this is what we do all day, every day. Our North Carolina Medicaid specialists have the resources, relationships, and know-how to help our clients maximize their benefits. When you file for Medicaid in North Carolina with us, you will receive all the answers and guidance you need during this particularly overwhelming junction of life. Whether you are a first-time applicant or need assistance with your annual Medicaid renewals in NC, we can help.

Benefit From Our NC Medicaid Services for Seniors


Gain from the following services offered by our North Carolina Medicaid consultants:
  • A free Medicaid Consultation
  • Assistance in obtaining 60 months of bank and financial statements from financial institutions' back offices.
  • Assistance in obtaining verifications from banks regarding checks, deposits, and cash withdrawals
  • All verification provided to satisfy Medicaid's requests.
  • Assisting families in utilizing excludable resources
  • Assisting clients in the process of liquidating life insurance policies, annuities, and stocks etc.
  • Obtaining missing documentation from the Vital Statistics office, if necessary
  • Consistent client updates on the application status
  • Applying to the county Board of Social Services
  • Liasing with the Board of Social Services caseworker regularly
The experts at Senior Planning Services are just a phone consultation away.
Let us replace your stress and anxiety with direction and clarity.
Give us a call at 855.775.2664 or
Contact us to get started

FAQs on Medicaid for Seniors in North Carolina

How do I apply for Medicaid in North Carolina?
Apply for Medicaid in North Carolina by submitting an application online through ePASS, by mail, or in person at your county Department of Social Services. Required documents include proof of income, identity, and residency. You can also apply by using the services of experts such as Senior Planning Services. Applications are typically processed within 45 days, or 90 days for disability-related cases.
Who is eligible for Medicaid in NC?
Eligibility for Medicaid in North Carolina depends on income, household size, and specific categories. Eligible groups include low-income families, pregnant women, children, seniors, and people with disabilities. Applicants must also be U.S. citizens or qualified non-citizens and residents of North Carolina to qualify for coverage.
Does Medicaid pay for assisted living in North Carolina?
Medicaid in North Carolina does not directly pay for assisted living room and board. However, it covers certain services in assisted living facilities through the Special Assistance program and Medicaid waivers. These services can include personal care, medical assistance, and limited financial support for eligible low-income residents.
What do I need to apply for Medicaid in NC?
Apply for Medicaid in North Carolina by providing proof of identity, Social Security number, residency in NC, income details, and resources such as bank statements. You also need information on household members and citizenship or immigration status. Submit these documents through your county Department of Social Services.
What services are covered for Medicaid applicants in North Carolina?
Medicaid in North Carolina covers doctor visits, hospital care, prescription drugs, mental health services, maternity care, vision exams, dental care for children, and nursing home services. It also includes preventive care, lab tests, and family planning. Some services may require small copayments.
How long does NC take to approve Medicaid?
North Carolina takes up to 45 days to approve a Medicaid application. If the application involves a disability determination, the process can extend to 90 days. The county Department of Social Services notifies applicants by mail once a decision is made.