Benefits for seniors in North Carolina

Medicaid for people 65 and over

North Carolina covers people 65 and over, and people who are blind or disabled, under Medicaid for the Aged, Blind and Disabled (MAABD). Your county DSS decides who qualifies.

• Income: About $1,330 a month for one person and $1,804 for a couple. Some income is not counted, so apply even if you are a little over.
• Savings (resources): $2,000 for one person, $3,000 for a couple.
• Over the limit? You may still get Medicaid with a deductible. This works like a spend-down: once your medical bills reach a set amount, Medicaid helps with the rest of that period.
• What it covers: Doctor visits, hospital care, prescriptions and more. If you also have Medicare, Medicaid fills many of Medicare's gaps.

Long-term care. Medicaid can pay for nursing home care, and for care at home through the CAP/DA program (see "Help staying at home"). Only your own income is counted for CAP. If you are married and your spouse stays at home, your spouse can keep part of the couple's savings. Ask your county DSS for the current amounts.

Estate recovery. After death, North Carolina may seek repayment from the estate of people 55 and over who got nursing home care, home and community care, or personal care services. It is waived if the estate is under $50,000 or Medicaid paid less than $10,000, and delayed while a spouse is alive. Call the NC Medicaid Contact Center at 888-245-0179.

Help paying Medicare costs

North Carolina calls its Medicare Savings Programs Medicare Qualified Beneficiaries (MQB). They use the federal income limits:

• MQB-Q (QMB): Pays your Part A and Part B premiums, deductibles and coinsurance. Income up to $1,350 a month for one person, $1,824 for a couple.
• MQB-B (SLMB): Pays your Part B premium. Income up to $1,616 a month for one person, $2,184 for a couple.
• MQB-E (QI): Pays your Part B premium. Income up to $1,816 a month for one person, $2,455 for a couple.
• Savings limit: $9,950 for one person, $14,910 for a couple.

If you get any of these programs, you also get Extra Help with Medicare drug costs automatically. Apply through your county DSS.

Prescription drug help

North Carolina does not have its own drug program for seniors. Your best option is Extra Help, the federal program that lowers Medicare Part D costs. If your income is under 150% of the poverty level, apply with Social Security. SHIIP can help you compare drug plans for free.

Extra state payment with SSI

North Carolina does not add money to the federal SSI payment for people who live on their own without help.

Instead, the state and counties pay State/County Special Assistance to people 65 and over (or adults with a disability) with low income:

• In an adult care home: For 2026, the maximum rate is $1,397 a month, plus a $70 personal needs allowance. Your payment is that total minus your own countable income.
• Special Assistance In-Home: For people whose doctor says they need adult care home level care but who want to keep living at home. The 2026 maximum is $1,397 a month, or $1,792 with a verified Alzheimer's or dementia diagnosis.
• Medicaid too: If you get Special Assistance, you automatically get Medicaid.

Apply at your county DSS.

Food help

SNAP is called Food and Nutrition Services (FNS) in North Carolina.

• Simplified program for older adults: If you are 65 or older, get SSI, and buy and cook your food apart from others in your home, you may qualify for the Simplified Nutritional Assistance Program. Your benefit is a set amount based on your housing costs. There is no interview unless you ask for one, and you stay approved for 36 months. The state often mails this application to people who qualify.
• Regular FNS: Anyone can apply online at epass.nc.gov, at your county DSS, or by mail. Benefits start from the day you turn in the application.
• Seniors Farmers Market Nutrition Program: If you are 60 or older and your income is no more than 185% of the poverty level ($2,461 a month for one person, $3,337 for two), you may get vouchers for fresh local produce. It runs July 1 to September 30 in participating counties. The 2026 season is closed; check back in late June 2027.
• Meals: Ask your Area Agency on Aging about home-delivered and community meals for older adults (see "Free help and counseling").

Help staying at home

• CAP/DA (Community Alternatives Program for Disabled Adults): A Medicaid program for adults who need nursing home level care but want to live at home. It pays for services and supports at home and in the community. Ask your county DSS or local CAP/DA agency.
• PACE (Program of All-Inclusive Care for the Elderly): For people 55 and over who need nursing home level care and live in a PACE service area. PACE covers doctors, adult day care, nursing, therapy, personal care, meals, rides and prescriptions.
• Special Assistance In-Home: A monthly payment to help you stay at home (see above).

Property tax and housing help

If you own and live in your home, you may get help from three programs. Apply to your county tax assessor, not the state, by June 1.

• Elderly or Disabled Exclusion: For owners 65 or older, or totally and permanently disabled. For the 2027 tax year, last year's income must be $39,900 or less. It removes the greater of $25,000 or 50% of your home's value from taxes.
• Circuit Breaker Tax Deferment: Same age rules. Your tax is limited to 4% of your income if you are at or under $39,900, or 5% if your income is up to $59,850. The rest is deferred, not forgiven. You must reapply every year.
• Disabled Veteran Exclusion: Removes up to $45,000 of your home's value. There is no age or income limit.

Help with energy bills

North Carolina's heating help is the Low Income Energy Assistance Program (LIEAP). It makes a one-time payment to your heating company. You do not pay it back.

• Who qualifies: Households that pay their own heating costs and meet an income test based on the poverty level.
• Seniors apply first: If someone in your home is 60 or older, you can sign up December 1 to 31. Other households apply January 1 to March 31, or until the money runs out.
• How to apply: Online at epass.nc.gov or through your county DSS.
• Emergencies: Ask your county DSS about the state's Crisis Intervention Program.

Free help and counseling

• SHIIP (Seniors' Health Insurance Information Program): North Carolina's free Medicare counseling service, run by the NC Department of Insurance. Counselors help with Medicare choices, drug coverage, Medicare supplements and long-term care insurance. They also help you spot billing errors and fraud through the NC Senior Medicare Patrol. Call 855-408-1212 (toll free).
• County Department of Social Services (DSS): Your county DSS handles Medicaid, Medicare Savings Programs, Special Assistance, food and heating help. Find yours at ncdhhs.gov/divisions/social-services/local-dss-directory, or call the NCDHHS Customer Service Center at 1-800-662-7030.
• Area Agencies on Aging: Local agencies connect you with meals, in-home help and other services. Find yours through the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov.

How to apply

Check what you may qualify for