Medicaid Eligibility in Durham, NC (2026)
Learn about Medicaid eligibility requirements in Durham, NC, including income limits, asset requirements, and how to apply for coverage in 2026.
Medicaid in
's Medicaid Program: NC Medicaid
In , the Medicaid program is known as NC Medicaid. This state-federal partnership provides health coverage to eligible low-income residents, including seniors aged 65 and older.
Medicaid is a joint federal-state program that provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. In , Medicaid helps seniors cover costs for nursing home care, home health services, prescription drugs, hospital stays, and doctor visits that Medicare doesn't fully cover.
For seniors, Medicaid often works alongside Medicare as "dual eligibility," covering costs like Medicare premiums, deductibles, and copayments, as well as long-term care services that Medicare doesn't cover.
Medicaid Expansion Status
has expanded Medicaid under the Affordable Care Act. This affects income eligibility thresholds for adults under 65.
2026 Medicaid Income & Asset Limits in
| Category | Individual | Couple |
|---|---|---|
| Monthly Income Limit | $1,732/month | $2,351/month |
| Asset Limit | $2,000 | $3,000 |
| Federal Poverty Level | 138% | |
Exempt Assets (Not Counted)
- Primary home
- One vehicle
- Personal belongings
Spousal Protections
When one spouse needs nursing home care, federal law protects the at-home spouse from impoverishment. The Community Spouse Resource Allowance (CSRA) lets the at-home spouse keep a portion of the couple's assets and a monthly income allowance.
How to Apply for Medicaid in
Processing Time
30-45 days
Documents Needed to Apply
- Photo ID
- Proof of income
- Proof of residency
- Social Security card
- Bank statements
Medicaid Programs for Seniors in
Aged, Blind, and Disabled
Coverage for seniors 65+ and people with disabilities
Eligibility: Income below SSI limits
Home and Community-Based Services
Waiver program for in-home care
Eligibility: Nursing home level of care needed
Medicaid Waiver Programs in
Medicaid waiver programs in allow the state to provide home and community-based services (HCBS) to people who would otherwise need institutional care. These programs help seniors remain in their homes and communities while receiving necessary care.
Home and Community-Based Services (HCBS) Waivers
Cover services like personal care, homemaker services, adult day care, respite care, and home modifications to help seniors live independently at home.
Medicaid Managed Care in
uses a managed care delivery system for its Medicaid program. Beneficiaries choose or are assigned a managed care plan that coordinates their health care services.
Many states deliver Medicaid services through managed care organizations (MCOs). Contact 's Medicaid agency to learn about managed care options in your area and how to choose or change plans.
Frequently Asked Questions
In Durham, the income limit for Medicaid eligibility is generally 138% of the Federal Poverty Level. Contact your local office for exact figures.
You can apply online, by phone, by mail, or in person at your local county office. Processing typically takes 30-45 days.
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