Medical Assistance

Medicaid and Health Choice Applications
Online Application

For a fast and simple way to apply for Medicaid and Health Choice for Children, you may apply online at ePASS. ePASS is a secure; web-based self-service tool that allows you to submit a Medicaid or North Carolina Health Choice for Children (NCHC) application online as well as apply for other programs such as Food and Nutritional Services. It provides easy-to-use instructions that will guide you through the process. It also allows you to do a pre-assessment to determine if you are potentially eligible for medical assistance.

A short video was created with information on:

Paper Application

You may also mail or bring the completed Medicaid Application to the Currituck County Department of Social Services. For convenience, there is also drop box located outside the front entrance where applications can be dropped off after normal business hours. This will begin the application process.

Additional forms will be required to be completed after the county evaluates your initial application for Medicaid.  The forms are available in English and Spanish.

Application for Health Coverage & Help Paying CostsDMA-5200DMA-5200
Application for Health Coverage & Help Paying Costs (Short Form)DMA-5201
Health Coverage from Jobs - Appendix ADMA-5202-ADMA-5202-A
American Indian or Alaska Native Family Member (AI/AN) - Appendix BDMA-5202-BDMA-5202-B
Designation of Authorized Representative - Appendix CDMA-5202-CDMA-5202-C
Income/Resources - Appendix DDMA-5202-DDMA-5202-D
Medical Bills - Appendix EDMA-5202-EDMA-5202-E

If possible, take the items listed below with you if you go to the Department of Social Services office to apply.

If you do not have some or all of these items, please apply anyway because it is very important to protect your application date. The Department of Social Services (DSS) can assist you in obtaining these items and information.

  • Certified birth certificates or other proof of citizenship/alien status for each individual applying for Medicaid or Health Choice for Children
  • Identity documents for each individual applying for Medicaid or North Carolina Health Choice for Children
  • Social security cards, social security numbers, or proof that you have made an application for a number from the Social Security Office, for each individual applying for Medicaid or Health Choice for Children
  • A copy of all pay stubs for last month
  • Copies of all medical or life insurance policies
  • A list of all cars, trucks, motorcycles, boats, etc. you or anyone in your household own, including the year, make, model, and vehicle identification number (VIN) for each item
  • Most recent bank statements
  • A list of all real property you own
  • Current financial statements/award letters from other sources of income, such as:
    • social security
    • retirement benefits
    • pensions
    • veteran benefits
    • and child support.

NOTE: You are not required to bring an application with you, but it may speed the process to print and fill in as much of the application as you can ahead of time if possible.

North Carolina Medicaid Dental Providers

Look under Currituck County, Dare County, Pasquotank County, and Out of State (for Virginia providers).