About NC Medicaid
New Rules for NC Medicaid
Starting January 1, 2027, most adults ages 19 through 64 enrolled under Medicaid expansion must renew their Medicaid every 6 months instead of once a year. Some adults in this group will need to report that they work, go to school or take part in volunteer activities to keep their full Medicaid benefits. Unless they have an exemption, they must complete 80 hours of work, go to school or volunteer for 3 of the 6 months during their certification period.
NOTE: American Indians and Alaska Natives will continue to renew their Medicaid once a year.
Members will need to check with their local Department of Social Services (DSS) on eligibility and requirements. Find your local DSS office at ncdhhs.gov/localdss. Call the NC Medicaid Contact Center at 1-888-245-0179 if you need help finding your local DSS.
Visit medicaid.ncdhhs.gov/HR1 or see the flier to learn more about these changes.
What is the Medicaid Waiver?
NC Medicaid provides health plans for serious behavioral health, traumatic brain injury (TBI), and intellectual/developmental disability for people receiving Medicaid. The Medicaid Waiver allows Trillium to be a Managed Care Organization (MCO) and Tailored Plan, which means we help manage the services and budget for Medicaid in our region. For people placed on the Tailored Plan, we cover physical health care and pharmacy services, too. People in NC Medicaid Direct also get physical services but they are not coordinated by Trillium.
If you get Medicaid from any of the counties in Trillium’s area and receive these services, you are a member of the Tailored Plan or NC Medicaid Direct.
- People with serious mental health disorders, substance use disorders, intellectual/developmental disability (I/DD), or traumatic brain injury (TBI) needs
- NC Innovations Waiver participants
- People who receive Medicaid AND Medicare
- People who are medically needy
- People in the HIPP program
- Children with CAP/C services
- People with CAP/DA services
- Children and youth in foster care
- Children and youth getting adoption help
- Former foster youth
Note
Other plans include the Standard Plan and EBCI Tribal Option. Please visit NCMedicaidPlans.gov for more information.
Available services include basic Medicaid services for North Carolina, plus some additional services for more serious behavioral health or I/DD conditions. Trillium prioritizes treatment in the most inclusive setting, attention to the whole person, and concentration on an individual's strengths.
To learn more about the Medicaid Waiver in North Carolina, visit NC Medicaid.
Getting Medicaid Services
There are a variety of ways to apply for Medicaid through your local Department of Social Services (DSS). The easiest way to apply is online at NCDHHS ePASS. If you cannot apply online, you can also:
- Apply in person at your local DSS office.
- Fill out a paper application and mail to or drop it off at your local DSS office.