ASHEVILLE, N.C. (828newsNOW) — By the end of 2023, an estimated 600,000 more people in North Carolina became eligible for Medicaid. Governor Roy Cooper recently announced more than 500,000 North Carolinians had already enrolled in the expanded services.

Nonprofit organizations like Pisgah Legal Services have helped facilitate hundreds of these enrollments in the western part of the state.

What is Medicaid?

Medicaid is a health coverage program, funded jointly by individual states and the federal government, for low income people of all ages. It covers medical expenses for those eligible. Medicaid varies from state to state and is run by state and local governments within federal guidelines.

In North Carolina, NC Medicaid can help pay for certain medical expenses including doctor bills, hospital bills, prescriptions, vision care, dental care and much more. It can also help pay for special services including serious mental illness, severe substance use disorders and more.

Who is eligible now that it’s been expanded in North Carolina?

Starting Dec. 1, 2023, NC Medicaid began covering people ages 19 through 64 years with higher incomes.

According to HealthInsurance.org, the following populations are eligible for Medicaid in North Carolina:

  • Children aged 0-5: 215% of the federal poverty level (FPL)
  • Children age 6-18: 138% of FPL
  • Pregnant women: 201% of FPL (postpartum coverage for the mother now continues for 12 months after the birth)
  • Adults caregivers of children or adult relatives: 45% of FPL
  • Adults under age 65 with household income up to 138% of the poverty level (this is the ACA’s expansion of Medicaid)

HealthInsurance.org also has a federal poverty level calculator to help people better estimate their eligibility.

As of March 2024, Medicaid.gov reported 75,645,578 individuals were enrolled in Medicaid across the U.S., including 2,285,299 in North Carolina. State data from July 3, 2024 (prior to Governor Cooper’s July 12 announcement) showed 499,362 North Carolinians had enrolled in expanded coverage.

How can local nonprofits like Pisgah Legal Services help?

Pisgah Legal Services is a nonprofit organization that provides legal assistance and advocacy to help low-income people in 18 counties across Western North Carolina. Katie Alexander is the regional director for Pisgah Legal Service’s central region, which encompasses Buncombe and Madison counties, for the Health and Economic Opportunity Program.

Through the Health and Economic Opportunity Program, Pisgah Legal helps people sign up for health insurance. The program combines the nonprofit’s Medicaid and Affordable Care Act (ACA) Navigator services with tax assistance. Since Medicaid expanded in North Carolina, Pisgah Legal has helped around 370 people within the western region of the state get signed up.

Alexander told 828newsNOW most people signing up for Medicaid now are low income folks who are working but not able to qualify for insurance through their jobs or on the Affordable Care Act marketplace.

“For a lot of them that’s been their first time getting health insurance in years and we’re working with folks who have not had health insurance in a long time,” she said. “So it’s kind of, I mean, it can be pretty life-changing to be able to go to the doctor, get things taken care of, be able to get that preventive care that they haven’t been able to have in so long.”

As far as helping people overcome obstacles when signing up for coverage, Alexander said most of the time people are afraid of answering questions wrong.

“I think that’s a huge thing that we see is people are just afraid of saying the wrong thing,” she said. “They don’t want to get in trouble. You have to estimate your income and for a lot of folks that can be really difficult. They, you know, have a job where they don’t know how much they’re going to make that month and they really don’t want to say the wrong thing.”

Alexander said they work with many people experiencing homelessness, so Pisgah Legal’s job is to make signing up for health care as easy and accessible as possible.

“If someone doesn’t have a phone, they don’t have access to the internet, they don’t have an address that they can regularly check their mail at, that can also be really difficult when they’re trying to sign up for health insurance coverage,” she said.

Alexander said that Pisgah Legal doesn’t just stop at helping people sign up for coverage, they also try to educate along the way and make sure people understand exactly what they’re signing up for and how to use it.

“That’s another big barrier is that some people get health insurance, but they haven’t had health insurance in maybe their entire adult life and so they’re not quite sure how to use it because it’s really complicated, and you have to go through the network and things like that,” she said. “So we try to walk folks through sort of that education piece of things to make sure people know how they got enrolled, what Medicaid is, and how they can use their Medicaid coverage.”

For anyone second guessing whether they’re eligible for Medicaid or not, Alexander encourages them to just call Pisgah Legal, stop by for a conversation or reach out to any other organizations helping people enroll.

CLICK HERE for more information from Pisgah Legal Services.