North Carolina Medicaid long-term care
The eligibility rules and the actual application path in North Carolina. We link to the state agency at every step and we do not submit anything for you.
Quick answer
Does North Carolina Medicaid pay for home care?
North Carolina Medicaid can pay for care at home through the Community Alternatives Program for Disabled Adults (CAP/DA) and related long-term services, but eligibility is a two-part test. You generally need financial eligibility for long-term care NC Medicaid in an aged, blind, or disabled category (MAA, MAB, MAD) or Health Care for Workers with Disabilities (HCWD), enrollment in NC Medicaid Direct, a nursing-facility level of care, and a need for at least one CAP/DA service — plus an available waiver slot. Some CAP/DA participants may have a deductible that depends on income. Exact 2026 income and asset dollar limits are still pending verification on this page against a single official DHB/DSS standards table. Apply for Medicaid through ePASS / county DSS first, then pursue CAP/DA referral — not through a home care agency.
What this page assumes you are paying for: what care costs in North Carolina — hourly, monthly and yearly, each figure with its source.
Who to apply with
Income and asset rules
Monthly income limit (LTC / CAP/DA categories)
Data pending verification. Not yet verified against the state agency for a single publishable figure on this page. We publish figures only after they are checked against the official source, with the source and review date shown. Check the state agency directly in the meantime.
Countable asset limit (applicant)
Data pending verification. Not yet verified against the state agency for a single publishable figure on this page. We publish figures only after they are checked against the official source, with the source and review date shown. Check the state agency directly in the meantime.
Community spouse resource allowance (CSRA)
Data pending verification. Not yet verified against the state agency for a single publishable figure on this page. We publish figures only after they are checked against the official source, with the source and review date shown. Check the state agency directly in the meantime.
Deductible / patient responsibility (income-related)
Data pending verification. Not yet verified against the state agency for a single publishable figure on this page. We publish figures only after they are checked against the official source, with the source and review date shown. Check the state agency directly in the meantime.
NC Medicaid CAP/DA pages note some adults may pay an out-of-pocket deductible that depends on income. Confirm current ABD LTC financial standards with your county Department of Social Services.
Home and community based services
- CAP/DA
1915(c) HCBS waiver for disabled adults 18+ who meet institutional level of care and need CAP/DA services to remain in the community. Referral and case management run through county CAP/DA entities and NCLIFTSS/e-CAP processes.
- Nursing facility Medicaid
Separate facility pathway still requires LTC Medicaid financial eligibility and level of care — apply through ePASS/DSS.
A waiver usually requires meeting both the financial rules and a functional (level-of-care) test. Waiting lists and slot availability vary by year.
How the application works
- 1. Apply for NC Medicaid through ePASS / county DSS
Apply online via ePASS (Medical Assistance). Disability-related decisions can take longer than standard 45-day timelines. · How to apply
- 2. Request CAP/DA referral
Contact the local CAP/DA case-management entity or use NCLIFTSS/Acentra referral channels. CAP/DA referral is not the same as the ePASS Medicaid application alone.
- 3. Level of care and needs assessment
CAP/DA requires institutional-equivalent level of care and a needs assessment showing need for at least one CAP/DA service.
- 4. Slot assignment and service plan
Enrollment depends on waiver capacity. Service plans are approved through the CAP/DA process before ongoing HCBS begin.
- 5. Choose services and providers
Case managers coordinate covered CAP/DA services — not this website.
Before you file
- Rules change annually — always confirm with NC Medicaid / your county DSS.
- Transfers of assets in the look-back period can create a penalty period. That is a question for an elder law attorney, not a website.
- You can apply directly. You never have to pay a service to file for you.
Common questions
Is the income limit the only test?
No. CAP/DA also requires nursing-facility level of care, need for at least one CAP/DA service, an available waiver slot, and active NC Medicaid Direct eligibility in an aged/blind/disabled (or HCWD) category.
Where do I apply?
Apply for NC Medicaid (Medical Assistance) through ePASS or your local Department of Social Services, then request a CAP/DA referral through your county CAP/DA case-management entity or NCLIFTSS/Acentra pathways. We do not submit applications for you.
Related
We are an independent informational and tools site. We are not a government agency, not a healthcare provider, and not a licensed referral agency under California CCR Title 22 or Florida Stat. 429.195. We do not place people into facilities and we do not charge families. Nothing here is legal, medical or financial advice — always confirm current rules with the state agency or a licensed professional.