North Carolina expanded Medicaid under the ACA effective December 1, 2023. ACA expansion Medicaid (covering low-income adults ages 19–64 generally) is a SEPARATE eligibility pathway from long-term-care Medicaid (aged/blind/disabled, nursing facility, and HCBS waiver eligibility), which has its own, generally lower income/asset tests described below. Expansion did not change nursing facility or waiver financial eligibility rules.
Two separate pathways
ACA expansion Medicaid covers low-income adults generally on an income basis. Long-term-care Medicaid for seniors uses the aged/blind/disabled (non-MAGI) pathway, with its own income and asset tests -- expansion did not change nursing facility or CAP/DA waiver eligibility rules.
NC's 2026 nursing facility Medicaid limits
| Asset limit, single | $2,000 (per NC DHHS 2026 Basic Medicaid Eligibility Requirements, Aged/Blind/Disabled resource limit) |
|---|---|
| Asset limit, couple (both applying) | $3,000 (per NC DHHS 2026 Basic Medicaid Eligibility Requirements, Aged/Blind/Disabled resource limit for a couple) |
| Personal Needs Allowance | $70/month for an institutionalized individual |
Confirm current figures with NC Medicaid before publishing -- these change annually.
