North Carolina expanded Medicaid on December 1, 2023. That single change transformed the reentry landscape: an estimated 80% of people releasing from North Carolina state prisons are now eligible for Medicaid coverage for the first time. The North Carolina Department of Adult Correction (NCDAC) has launched a department-wide effort to enroll eligible individuals 90 days before their projected release date, with the goal of having coverage active on the day they walk out the door.
North Carolina is also a Reentry 2030 state with specific public commitments on Medicaid, mental health treatment, education credentials, and local reentry council coverage. The NC ID Project provides free assistance to recently released individuals who need help securing a state ID. And the Recidivism Reduction Call Center (1-888-852-0004) connects returning citizens to resources in every North Carolina county.
Here is how the system works and what you need to do.
Medicaid in North Carolina
North Carolina expanded Medicaid effective December 1, 2023. Adults ages 19 to 64 with incomes at or below 138% of the federal poverty level are now eligible. This is a major development for people leaving North Carolina state prisons -- approximately 80% are newly eligible.
Pre-release enrollment: NCDAC has launched a department-wide effort to help people within 90 days of their release date apply for Medicaid. Because a Medicaid application can take up to 45 days to process, starting 90 days out is critical to having coverage active on release day. Approximately 100 Medicaid applications per week were being submitted through NCDAC's pre-release process as of early 2024. Ask your case manager or social work staff whether your Medicaid application has been submitted and what its status is.
If you did not apply before release: Check your eligibility and apply online through NC Medicaid at medicaid.ncdhhs.gov or by contacting your local Department of Social Services. Medicaid can cover doctor visits, behavioral and mental health treatment, prescription drugs, and other services.
Medicaid suspended during incarceration: As of January 1, 2025, Medicaid beneficiaries whose benefits were suspended during incarceration will be placed in NC Medicaid Direct (or the EBCI Tribal Option, if eligible) upon release and will remain excluded from Medicaid managed care for up to 365 days following release. This allows easier access to physical health providers and reduces system transitions during the post-release period. Contact NC Medicaid or your local DSS if you have questions about your coverage status after release.
North Carolina 1115 Reentry Waiver (Pending CMS Approval)
North Carolina applied for a Medicaid Reentry Section 1115 Demonstration waiver to provide pre-release Medicaid services to eligible incarcerated individuals in the 90 days before release. Under this waiver, North Carolina plans to provide services at all 53 state prisons and at select county and tribal facilities. Minimum services would include case management to assess health and social needs, pre-release behavioral health visits, and a 30-day supply of all prescription medications in hand at release. Additional services -- physical health consultations, laboratory and radiology services, tobacco cessation, and durable medical equipment at release (wheelchairs, walkers) -- will be phased in. Confirm the current CMS approval status of North Carolina's 1115 reentry waiver at medicaid.ncdhhs.gov or with your NCDAC case manager, as CMS approval was pending as of late 2024.
Youth Medicaid (CAA 2023, effective January 1, 2025): NC Medicaid has begun phasing in federally mandated services for justice-involved youth in Youth Development Centers (YDCs). Screening and diagnostic services are covered in the 30 days before release. Reentry care management (including a full year post-release) is being phased in beginning 2025. LME/MCOs provide pre- and post-release care management. Tribal youth receive services through the Cherokee Indian Hospital Authority.
Getting Your North Carolina State ID or Driver's License
North Carolina state IDs and driver's licenses are issued by the NC Division of Motor Vehicles (NCDMV, ncdot.gov/dmv).
NC ID Project: Disability Rights North Carolina operates the NC ID Project, which provides free assistance to people recently released from prison who need help securing their state ID. Contact them at 1-888-938-6832 or ncid.project@disabilityrightsnc.org.
Driver's license suspensions: Approximately 1 in 10 North Carolina licensed drivers has a suspended license due to unpaid traffic fines, fees, or missed court dates. This is a significant reentry barrier. The North Carolina Justice Center has compiled information and tips on how to begin resolving debt-based driver's license suspensions. Contact them at ncjustice.org or contact Legal Aid of North Carolina (legalaidnc.org) for free assistance.
Ask your NCDAC case manager or social work staff whether the facility can assist with ID document processing before release.
Getting Your Social Security Card
If your Social Security card was not obtained before release, contact the Social Security Administration at 1-800-772-1213, apply online at ssa.gov, or visit your nearest SSA office. Replacement cards are free. Bring your state ID and birth certificate.
Ask your case manager whether your facility has a prerelease SSA agreement allowing the card replacement and benefit application process to begin up to 90 days before release.
Getting Your Birth Certificate
If you were born in North Carolina, request a certified copy from the NC Department of Health and Human Services Vital Records at vitalrecords.nc.gov or by calling (919) 733-3526. The fee is currently $24 per copy.
If you were born in another state, contact that state's vital records office. Start this process early -- out-of-state requests can take time and delay your ID process.
SNAP: Food Assistance
North Carolina has no drug conviction SNAP ban. People with drug felony convictions are eligible for SNAP subject to standard income and eligibility requirements.
Apply for SNAP through your local Department of Social Services or at ncdhhs.gov/divisions/social-services/food-nutrition-services.
Voting Rights in North Carolina
North Carolina restores voting rights upon completion of your sentence, including any period of probation or parole. You cannot vote while incarcerated or while on probation or parole for a felony conviction in North Carolina. Once all supervision is complete, your voting rights are restored automatically.
Register to vote at voteforchange.ncsbe.gov after your supervision ends. Contact Legal Aid of North Carolina (legalaidnc.org) or the NC State Board of Elections (ncsbe.gov) if you have questions about your specific eligibility.
Note: The North Carolina Supreme Court has issued decisions affecting voting rights during probation and parole in recent years. Confirm the current legal status of voting rights restoration during probation and parole with Legal Aid of NC or the NC State Board of Elections at publish time.
NCDAC Reentry 2030 Commitments
North Carolina joined the national Reentry 2030 initiative. Key state commitments include:
Medicaid upon release for 100% of eligible individuals.
Treatment upon release for 100% of people diagnosed with serious mental illness, substance use disorders, or significant cognitive impairments.
75% increase in high school diplomas and education credentials earned during incarceration.
50% increase in registered apprenticeship and work release completion during incarceration.
Expansion of local reentry councils to cover all 100 North Carolina counties.
Current progress: $99 million secured to strengthen community-based mental health and SUD services. Increased the number of state prisons providing medication for opioid use disorder. Published a searchable online database of all coursework and apprenticeships at each prison. Created a senior housing policy position at NCDAC.
NCDAC and NC Reentry Resources
NCDAC Reentry (dac.nc.gov/programs/reentry): Pre-release Medicaid enrollment (90 days out); social work services; Reentry 2030 commitments; 28 Local Reentry Councils in 46 counties.
NC Medicaid (medicaid.ncdhhs.gov): Medicaid applications; expansion (effective December 1, 2023); 1115 reentry waiver status.
NC ID Project (Disability Rights NC; 1-888-938-6832; ncid.project@disabilityrightsnc.org): Free ID assistance for recently released individuals.
Recidivism Reduction Call Center (1-888-852-0004; Mon-Fri 9am-5pm): Staffed by formerly incarcerated certified community health workers; 800+ resource entries by county; housing, employment, mental health.
OurJourney (ourjourney.info): County-specific reentry resource guides across North Carolina; searchable by county.
NC FIT Program (NC Formerly Incarcerated Transition Program): UNC Family Medicine-founded program connecting formerly incarcerated individuals with chronic diseases or SUD to health care services.
Benevolence Farm (Alamance County): Housing and employment program for women recently released from NC prisons.
Legal Aid of North Carolina (legalaidnc.org): Free civil legal assistance statewide including ID, driver's license, housing, and reentry matters.
NC Justice Center (ncjustice.org): Debt-based driver's license suspension resources and reform information.
211 North Carolina (dial 211 or nc211.org): Statewide referrals to housing, food, health, and social services by county.
Social Security Administration (ssa.gov; 1-800-772-1213): SSI and SSDI applications; SSA Reentry Benefits at ssa.gov/reentry/benefits.htm.
Frequently asked questions
Does NCDAC help with Medicaid before release?
Yes. NCDAC launched a department-wide effort to submit Medicaid applications for eligible individuals within 90 days of their projected release date. Because processing can take up to 45 days, starting early is critical to having coverage active on release day. NCDAC was submitting approximately 100 applications per week as of early 2024. Ask your case manager or social work staff whether your Medicaid application has been submitted and what its status is. If it has not been initiated, ask them to start the process.
Can I get Medicaid after prison in North Carolina?
Yes. North Carolina expanded Medicaid on December 1, 2023. An estimated 80% of people releasing from NC state prisons are now eligible. Adults ages 19 to 64 with income at or below 138% of the federal poverty level qualify. Apply through your local DSS or at medicaid.ncdhhs.gov. NCDAC aims to have coverage active on release day through pre-release enrollment.
What is North Carolina's 1115 reentry waiver?
North Carolina applied to CMS for a Medicaid Reentry Section 1115 Demonstration waiver to provide pre-release Medicaid services to eligible incarcerated individuals in the 90 days before release. Under this waiver, services would be available at all 53 state prisons and select county and tribal jails. Minimum services would include case management, behavioral health visits, and a 30-day supply of all prescription medications in hand at release. Confirm the current CMS approval status at medicaid.ncdhhs.gov or with your NCDAC case manager.
Can I get SNAP benefits after prison in North Carolina?
Yes. North Carolina has no drug conviction SNAP ban. People with drug felony convictions are eligible for SNAP subject to standard income and eligibility requirements. Apply through your local Department of Social Services or at ncdhhs.gov/divisions/social-services/food-nutrition-services.
Can I vote after prison in North Carolina?
Voting rights are restored upon completion of your full sentence, including any period of probation or parole. You cannot vote while incarcerated or while on supervision for a felony conviction. Once all supervision ends, your voting rights are automatically restored -- register at voteforchange.ncsbe.gov. Note: NC Supreme Court decisions have affected voting rights during probation and parole in recent years -- confirm current legal status with Legal Aid of NC (legalaidnc.org) or the NC State Board of Elections (ncsbe.gov) at publish time.
How do I get my birth certificate in North Carolina?
If you were born in North Carolina, request a certified copy from NC Vital Records at vitalrecords.nc.gov or by calling (919) 733-3526. The current fee is $24 per copy. Ask your NCDAC case manager whether the facility can assist with this before release. If you were born in another state, contact that state's vital records office early -- out-of-state requests take time.
How do I replace my Social Security card in NC?
Contact SSA at 1-800-772-1213, apply online at ssa.gov, or visit your nearest SSA office. Replacement cards are free. Bring your state ID and birth certificate. Ask your case manager whether your facility has a prerelease SSA agreement allowing this to begin up to 90 days before release. SSA reentry benefits information is at ssa.gov/reentry/benefits.htm.
What is the NC FIT program?
NC FIT (North Carolina Formerly Incarcerated Transition Program) was founded by a UNC Family Medicine physician and connects formerly incarcerated individuals who have a chronic disease and/or substance use disorder to health care services. It provides a bridge between the corrections system and community-based medical care. Contact your local reentry council or call the Recidivism Reduction Call Center (1-888-852-0004) for referral information.
What benefits can I apply for after release in NC?
Medicaid at medicaid.ncdhhs.gov (80% of NC prison releasees eligible since December 2023 expansion). SNAP (food assistance) through your local DSS or ncdhhs.gov -- drug convictions do not bar you. SSI or SSDI through SSA (1-800-772-1213) if you qualify through age or disability. Veterans' benefits through the VA if applicable. 211 NC (dial 211 or nc211.org) for county referrals. Call the Recidivism Reduction Call Center (1-888-852-0004) for housing, employment, and mental health resources by county.
What reentry resources does NCDAC provide?
NCDAC (dac.nc.gov) provides: pre-release Medicaid enrollment (90 days out; goal 100% of eligible individuals); 28 Local Reentry Councils in 46 counties (goal: all 100 counties); Reentry 2030 commitments including mental health and SUD treatment; medication for opioid use disorder at more NC state prisons; a searchable online database of coursework and apprenticeships available at each prison. NC ID Project (1-888-938-6832) provides free ID assistance post-release. Recidivism Reduction Call Center (1-888-852-0004) provides county resource referrals staffed by formerly incarcerated certified community health workers. OurJourney (ourjourney.info) provides county-specific reentry resource guides. ---