Portrait of an african young nurse helping old elderly disable man grandfather to walk using walker equipment in the bedroom.

Medicaid is a government-sponsored health insurance program that provides coverage for eligible individuals who meet certain income and other eligibility requirements. Eligibility for Medicaid is determined by the state and may vary depending on the state where you live.

To be eligible for Medicaid in North Carolina, you must:

  • Be a resident of North Carolina
  • Meet certain income and asset limits. The income limit varies by household size, and eligibility is based on a percentage of the federal poverty level.
  • Meet certain medical criteria, such as having a disability or chronic medical condition that requires ongoing medical care.
  • Meet specific eligibility requirements for certain Medicaid Health Choice programs, such as being pregnant or being a child under the age of 19.

Apply for Medicaid
Eligibility Requirements

Procedure For Medicaid Recipient

  • STEP 1 Download the form below and take it to your primary doctor, nurse practitioner, Or specialist and explain your need for in-home care.
  • STEP 2 Have your doctor fill out pages 1 & 2 in their entirety and fax the completed form to NC LIFTSS via fax at 1-833-521-2626 (toll free).
  • STEP 3 A nurse will call and set a time to assess your needs in your home. (Keep in mind this is a service for recipients that need hands-on personal care, not simply housekeeping, laundry, or meal preparation).
  • STEP 4 We’d love to be your home care agency of choice. You will be given a list of home care agencies and asked to choose one.

View, download, and print the necessary “Request for Independent Assessment for Personal Care Services (PCS) Attestation of Medical Needs” form below. Download Form