Changes are coming to Medicaid

• By Todd Luck
• Posted Friday, September 4, 2026

Changes are coming to Medicaid starting October 1 that will affect who qualifies for it and what the requirements are for Medicaid Expansion.

The state has a website that allows residents to check on how the changes will affect them.

You can also see the information about the new requirements and what you can do to prepare for them.

New Requirements

For non-U.S. citizens, new federal rules begin on Oct. 1, 2026. Only the following non-citizens will be eligible for Medicaid:

• Lawful permanent residents (people with a green card)
• Children up to age 19 and women who are pregnant or within 12 months postpartum (after birth), who are lawfully residing in the United States but do not have permanent immigration status
• People with Cuban or Haitian entrant status
• Citizens of the Freely Associated States (Micronesia, Marshall Islands or Palau) living in the U.S.

For adults ages 19 through 64 without a disability who receive Medicaid through expansion, new rules start on Jan. 1, 2027. They will need to earn $580 each month per household to keep Medicaid or prove they are working, go to school or volunteer for 80 hours each month. People who do not meet the new rule may lose full Medicaid benefits, including coverage to go to doctors or dentists, get prescriptions or receive mental health care. Beginning in January, this population will have reviews every six months.

Some people will not have to meet the new work requirements, including:

• Parents, guardians, caretaker relatives or family caregivers for a child under age 14 or a person with a disability
• Anyone who has been determined by NC Medicaid as having a disability
• Women who are pregnant or were pregnant in the last 12 months

There are many other exceptions. More information is available on the state’s website, and Forsyth residents can contact Forsyth County Department of Social Service at 336-703-3800.

Medicaid renewals are also changing for people with Medicaid expansion. Starting Jan. 1, 2027, most adults ages 19 through 64 will renew their Medicaid every six months instead of once per year. When it is time for people to renew, their local DSS will mail them a letter if they need additional information.

What you can do now

There are five steps people can take now.

1. See if the work requirements apply to you on the state website or by contacting Forsyth DSS at 336-703-3800
2. Make sure your local DSS has your correct address and phone number.
3. Respond to any letter as soon as you get it.
4. Save important papers. Keep things like pay stubs, school records and volunteer logs, benefit letters or medical records which may be needed as proof to keep your Medicaid coverage.
5. Create an enhanced ePASS account if you do not already have one. You can use it to upload documents to show proof of work, school or volunteer activities.

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