Family Planning Medicaid in North Carolina is a limited Medicaid program that covers contraception, reproductive health exams, and STI screening and treatment for residents whose income falls below a certain threshold. It is not full Medicaid. It covers only family planning services and closely related care, nothing else.
Who Qualifies
To be eligible, you must live in North Carolina, be a U.S. citizen or have an eligible immigration status, and have a Social Security number (or proof you’ve applied for one). Families that include non-citizens can still apply, and applying will not affect anyone’s immigration status or path to permanent residency.
The income limit is based on household size. For a single person, the cutoff is roughly $2,544 per month. Larger households have proportionally higher limits. This threshold is set well above the federal poverty level, which means many working adults who earn too much for regular Medicaid may still qualify for the Family Planning program specifically.
What It Covers
The program pays for a focused set of reproductive health services:
- Contraception: birth control prescriptions, devices (like IUDs and implants), and their removal
- Reproductive health exams: gynecological visits, Pap smears, and related lab work
- STI screening and treatment: testing and treatment for sexually transmitted infections
- Sterilization procedures: voluntary sterilization for those who choose it
- Pharmacy and lab services: prescriptions and laboratory tests tied to family planning
Counseling about your contraceptive options is included, so you can discuss which method works best for your health and lifestyle at no cost.
What It Does Not Cover
This is where the program catches people off guard. Family Planning Medicaid is narrow by design. It will not pay for:
- Emergency room visits or ambulance services
- Inpatient hospital stays
- Prenatal care, labor, or delivery
- Treatment for medical conditions unrelated to family planning, even if discovered during a covered exam
- Abortions
- Hysterectomies
If a provider discovers a health issue during a family planning visit, such as an abnormal lab result or a chronic condition, they are required to refer you to a primary care provider or a safety net clinic. The Family Planning program itself will not cover follow-up treatment for that issue. You also lose eligibility if you’ve been sterilized or no longer need family planning services.
How Medicaid Expansion Changed Things
North Carolina expanded Medicaid in December 2023, and that directly affected the Family Planning program. When expansion took effect, the state contacted roughly 260,000 people enrolled in limited Family Planning Medicaid to let them know they could transition to full Medicaid benefits, which covers doctor visits, hospital care, prescriptions, mental health services, and much more.
Not everyone on the Family Planning program automatically moved to full coverage. Some people’s income exceeds the new full Medicaid threshold, even though it’s higher than it used to be. If you’re currently on Family Planning Medicaid, it’s worth checking whether you now qualify for full benefits, since the expanded income limits cover more people than before.
How to Apply
You apply for Family Planning Medicaid the same way you’d apply for any NC Medicaid program. There are three options.
Online: Use the state’s ePASS portal. You’ll need to create an NCID first, which is a secure login for North Carolina government services. On the application itself, Medicaid is listed as “Medical Assistance.”
In person: Visit your local Department of Social Services (DSS) office. Walk-ins are accepted everywhere, but calling ahead to schedule a phone or in-person interview can save you time. You can find your local DSS by calling the NC Medicaid Contact Center at 1-888-245-0179.
By mail, fax, or email: Download and print the application from the NC Medicaid website, fill it out, sign it, and send it to your local DSS office. Include copies of any supporting documents you have, such as proof of income, identity, and residency.
Family Planning vs. Full Medicaid
The key distinction is scope. Full NC Medicaid functions like comprehensive health insurance: it covers primary care, specialists, hospital stays, mental health, prescriptions, and more. Family Planning Medicaid is a single-purpose program. It exists so that people who don’t qualify for full Medicaid (or who haven’t yet enrolled) can still access contraception and basic reproductive health care at no cost.
If your income is low enough for Family Planning Medicaid, there’s a good chance you also qualify for full Medicaid under expansion. Applying through ePASS or your local DSS will determine which programs you’re eligible for. You don’t need to apply separately for each one.