How to apply
Fill out one simple form -- it's easy! You apply for both
the Health Check (Medicaid) and NC
Health Choice for Children programs at the same time.
Based on your information, your local Department of Social
Services (DSS) will decide which program your child qualifies
Step 1. Get an Application
You can get an application any one of the following ways:
- Print out an English application
here. If you are viewing this web site in a public place
(i.e. library, school) you may need to ask for help. (The
application is a PDF file. To view it, the computer needs
to have Adobe Acrobat Reader installed. If Acrobat Reader
is not installed, it can bedownloaded
here for free.)
- Pick up an application at yourlocal
Department of Social Services (DSS) office or health
Step 2. Fill Out the Application
Collect the information you need and complete the application.
Do You Need Help?
If you'd like help filling out the application, visit your
local Department of Social Services. Be sure to bring:
- The birth certificate and social security number of each child for whom you are applying.
- Proof of the family's income information (most recent month's pay stubs).
- Proof of residency (that you live in the county) and citizenship (government issued ID).
Are You Self-employed?
If you are self-employed and are paid
at least monthly, bring your business records (income
and expenses) for the last six months, or for the number
of months in business if less than six months.
If you are paid less often than monthly,
bring your business records (income and expenses) for the
last 12 months.
Step 3. Get Your Application to Your County's Department
of Social Services
What happens next?
See "After you apply"!
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Last updated: May 2015