Forsyth County Warns Medicaid Rules Change Oct. 1, Work Requirements Begin Jan. 1

Forsyth County is alerting residents to upcoming changes in Medicaid eligibility and renewal rules, with the first changes taking effect Oct. 1, 2026.

Under the new federal rules, Medicaid eligibility for certain non-U.S. citizens will narrow beginning Oct. 1. Forsyth County says eligible groups will include lawful permanent residents, certain lawfully residing children and pregnant or postpartum women, people with Cuban or Haitian entrant status, and citizens of the Freely Associated States living in the United States.

A second major change begins Jan. 1, 2027 for many adults ages 19 through 64 without a disability who receive coverage through Medicaid Expansion. Those adults will generally need to earn at least $580 per household each month or document 80 hours per month of work, school or volunteer activity unless they qualify for an exemption. Forsyth County says people who do not meet the requirement could lose full Medicaid benefits.

Medicaid Expansion renewals will also become more frequent for most affected adults, moving from annual reviews to reviews every six months beginning in January. Exemptions apply to several groups, including some caregivers, people determined by NC Medicaid to have a disability, and people who are pregnant or were pregnant within the previous 12 months.

Forsyth County residents who need help can contact the Department of Social Services at 336-703-3800. The county is also directing residents to NC Medicaid's state resources for additional information about the changes and exemptions.