Application Information

Individuals must complete an application. Applications are available at our office located at 319 N. Graham-Hopedale Road, Suite C, Burlington, NC 27217. You can complete it while you are here or mail the completed application to the following address: 319 N. Graham-Hopedale Road, Suite C, Burlington, NC 27217.

Bringing the following items will aid in the application process:

� Birth certificates or other legal proof of age for children under age 21

� A copy of all pay stubs for the prior month

� Social security cards or numbers for all household members

� Copies of all medical or life insurance policies for all persons you are applying

� A list of all cars, trucks, motorcycles or any other vehicles you or anyone in your household own

� Most recent bank statements

� Current statements for any other source of income such as child support

� Proof of alien status for applicants who are not US citizens

� Proof of pregnancy (a statement from your doctor or another health professional) if you are applying for pregnancy coverage.

� Name and phone number of at least 1 person who can verify who lives with you

Receipt of a completed application form begins the application process. Each child is first evaluated for Medicaid before being evaluated for NC Health Choice. Approved NC Health Choice applicants receive a health insurance card from Blue Cross/Blue Shield for each child, a benefits booklet, and instructions in the mail.

Unlike Medicaid (Health Check), NC Health Choice is limited by the amount of funds that are available. Therefore, the program is open only to children on a first come, first serve basis. When funds are used up, children will be placed on a waiting list.

For more information please see our North Carolina Health Choice FAQ page.