Application for Medicaid - NC DHHS Online Publications - NC ... - info dhhs state nc 2026

1. Click ‘Get Form’ to open the Application for Medicaid in the editor.
2. Begin by filling out Section 1, which asks for your personal information. Ensure that you provide your full name, date of birth, and Social Security number where required.
3. Proceed to Section 2 if you are applying for your spouse. Fill in their details similarly, including their Social Security number and date of birth.
4. In Section 3, provide your mailing address and any other relevant addresses. If applicable, indicate if you live in a nursing home.
5. Complete Sections 4 through 15 by answering questions about dependents, income sources, assets, and any medical bills. Be thorough to ensure all necessary information is captured.
6. Review all sections for accuracy before signing the application on the designated page. Your application cannot be processed without a signature.
7. Finally, save your completed application and either print it to mail or submit it electronically if available through our platform.

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