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  1. Download and fill out a printable application to apply by: Mail, email or fax. In person (to fill out the form ahead of time) Download Printable Application (PDF) If you are a single adult with no dependents or health care coverage from your employer, use the “short form” application (DHB-5201-ia).

  2. Medicaid Funded Long-term Care Service Authorization (PDF) Notification of Change (PDF)

  3. Use this application to see what coverage choices you qualify for • Affordable private health insurance plans that offer comprehensive coverage to help you stay well. • A new tax credit that can immediately help pay your premium for health coverage. • Free or low-cost insurance from Medicaid or the Children’s Health Insurance Program ...

  4. • Use this application to apply for anyone in your family. • Apply even if you or your child already has health coverage. You could be eligible for lower-cost or free coverage. • If you’re single, you may be able to use a short form. Visit

  5. Find out more on Medicaid and CHIP flexibilities, coverage, and benefits related to COVID-19. The Medicaid continuous enrollment condition, authorized by the Families First Coronavirus Response Act, ended on March 31, 2023.

  6. Print Form . Application for Health Coverage & Help Paying Costs (Short Form) Use this application to see what coverage choices you qualify for • Affordable private health insurance plans that offer comprehensive coverage to help you stay well • A new tax credit that can immediately help pay your premiums for health coverage

  7. You can apply for Medicaid any time of year in one of the following ways: Find and check with your state's Medicaid agency to apply. You must be a resident of the state where you are applying for benefits. Create an account with the Health Insurance Marketplace and fill out an application.

  8. Jan 12, 2024 · In this Medicaid application guide, we outline the paperwork needed to apply for Medicaid, where you can get the required Medicaid application forms and how you can get started signing up for Medicaid.

  9. To receive NC Medicaid, a person must: Be a U.S. citizen or have an eligible immigration status. Live in North Carolina. Have a Social Security number or show you have applied, if you are eligible for one.

  10. Medicaid provides access to free and low-cost medical care. State residents eligible for Medicaid support (sometimes referred to as Medical Assistance) include pregnant women, children, retirees age 65 and older, and people who are legally blind or disabled.

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