STATE PROFILE • Last updated: November 11, 2026
North Carolina Elder Care & Medicaid
North Carolina offers long-term care for seniors through Nursing Home Medicaid, Home and Community-Based Services (HCBS) Waivers, and a Medically Needy pathway, with strict asset limits.
leaderboard
RANKED #34
GRADE C
FEATURED
Medicaid Coverage Guide for North Carolina
Full breakdown of NC Medicaid, Division of Health Benefits (North Carolina Department of Health and Human Services) for seniors: waiver programs, nursing home eligibility, income and asset limits, spend-down rules, and how to apply.
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Program
NC Medicaid, Division of Health Benefits (North Carolina Department of Health and Human Services)
Income cap
No cap
Medically-needy
Yes
Elder Care Index Report Card
5-pillar composite scoring vs other states
C
Grade
AFFORDABILITY
GRADE C · 70
QUALITY
GRADE C · 48
STAFFING
GRADE D · 24
ACCESS
GRADE D · 24
MEDICAID SUPPORT
GRADE C · 27
Composite score: 42.3 / 100 (50 = average state)
Methodology arrow_forward
North Carolina At a Glance
Nursing Home Facilities
418
Senior Medicaid Waivers
2
National Rank
#34 / 51
Range #33–#35 when the pillar weights shift
Senior Care Costs in North Carolina
local_hospital
Nursing Home
$9,086/mo
-17.7% vs national avg
- 418 nursing homes · 43,796 beds
- Avg CMS rating 2.91★ (81 rated 5★, 87 rated 1★)
- 3.78 nurse hrs/resident/day (0.59 RN)
Source: CMS Nursing Home Compare
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home_health
Home Health Aide
$24/hr
-11.1% vs national avg
- Median aide wage $14.47/hr
- ~59,880 aides employed statewide
Source: BLS OEWS
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