Expansion Means those 19-64 are Eligible, Including Some With Higher Incomes

The Centers for Medicare and Medicaid Services (CMS) is mailing letters to 534,840 North Carolinians based on information provided to HealthCare.gov that indicates they may be eligible for NC Medicaid. With the expansion of Medicaid, more people are eligible, including those ages 19 through 64 years with higher incomes.

The letters, which started arriving in mailboxes February 1, directs individuals to contact HealthCare.gov to update their information currently available in their HealthCare.gov case file. Sample letters are available on the Medicaid website.

NC Medicaid began accepting Federally-facilitated Marketplace Eligibility Determinations (FFM-D) February 1, 2024. This change allows the FFM to make the eligibility determination for individuals who apply for coverage through the Federal Marketplace at HealthCare.gov and whose eligibility is determined following modified adjusted gross income (MAGI) rules.

This change means NC residents who apply for Medicaid through the Federal Marketplace (HealthCare.gov) and are determined fully eligible for Medicaid by the FFM will no longer require an eligibility determination by the local Department of Social Services (DSS) caseworker. Once NC Medicaid receives notification of eligibility, NC FAST will review the case to determine which full MAGI benefit program the individual qualifies for and will send the appropriate final notice of eligibility to the individual. [source]