Key Takeaways
• Medicaid eligibility in North Carolina depends on immigration status, income, and includes a five-year waiting period.
• Non-citizens can get North Carolina driver’s licenses with legal status and must get REAL ID by May 7, 2025.
• Senate Bill 153 may increase immigration enforcement and restrict benefits, pending State House vote in April 2025.
As of July 2025, non-citizens living in North Carolina face a mix of benefits and restrictions when it comes to healthcare, driver’s licenses, and other state-level services. These rules affect thousands of people, including international students, workers, families, and undocumented immigrants. The state’s policies are shaped by both federal laws and local decisions, and recent changes have made it even more important for non-citizens to understand their rights and responsibilities.
This article explains what non-citizens in North Carolina can expect in 2025, focusing on healthcare access, driver’s license eligibility, and new laws that could change the way immigrants live and work in the state. We’ll look at who qualifies for what, how to apply, and what changes may be coming soon.
Who Can Get Healthcare in North Carolina?
Healthcare is one of the most important issues for non-citizens. In North Carolina, the rules depend on your immigration status, your income, and sometimes your age or whether you’re pregnant.
Medicaid: Who Qualifies and Who Doesn’t
Medicaid is a government health insurance program for people with low income. In North Carolina, only certain non-citizens can get full Medicaid benefits. To qualify, you must:
- Have a Qualified immigration status (such as lawful permanent resident, refugee, or asylee)
- Meet income and residency requirements
Qualified immigration status means you are legally allowed to live in the United States 🇺🇸 under certain categories. This includes green card holders, refugees, asylees, and some others recognized by federal and state law. However, even with a qualified status, many immigrants must wait five years before they can get full Medicaid coverage. This is called the “five-year bar.”
Income limits for Medicaid in 2025 are:
- Single adult: $1,800 per month or less
- Family of 2: $2,433 per month or less
- Family of 3: $3,065 per month or less
- Family of 4: $3,698 per month or less
- Family of 5: $4,340 per month or less
These numbers change each year, so it’s important to check the latest guidelines on the North Carolina Medicaid website.
Emergency Medicaid: Help in Urgent Situations
If you are an undocumented immigrant, you cannot get full Medicaid coverage. However, you may qualify for emergency Medicaid. This program pays for urgent medical care, such as childbirth or treatment for life-threatening conditions, no matter your immigration status. Emergency Medicaid does not cover regular doctor visits, check-ups, or long-term care.
Special Rules for Children and Pregnant Women
Some children and pregnant women who do not have permanent legal status may still qualify for full Medicaid coverage. The rules are complex and depend on several factors, including income and specific immigration categories. It’s best to contact the North Carolina Department of Health and Human Services (NCDHHS) for help with these cases.
Medicaid Expansion and Policy Updates
North Carolina expanded Medicaid in December 2023, making more people eligible based on income. However, immigration status is still a key factor. Only those with the right status can get full benefits. The NCDHHS updated its rules in May 2024 to make this clear.
Can Non-Citizens Get a Driver’s License in North Carolina?
Having a driver’s license is important for daily life—getting to work, school, or the doctor. In North Carolina, non-citizens can apply for a driver’s license or a state ID card, but there are special steps and requirements.
Who Can Apply?
Non-citizens, including international students and scholars, are eligible to get a North Carolina driver’s license or a state ID card. Here’s what you need to know:
- Driver’s license: Lets you drive and serves as official identification
- State ID card: Serves as identification only; does not allow you to drive
How to Apply: Step-by-Step
- Check Your Immigration Status:
You must have legal status in the United States 🇺🇸. This includes students with valid visas, green card holders, refugees, and others with approved documents. -
Complete Immigration Check-In:
International students and scholars must finish an online and in-person check-in with their school’s Center for Immigration Services & Support before going to the DMV. -
Update SEVIS Registration:
The DMV uses the SAVE system to check your status. Make sure your SEVIS record is updated 7–10 days before your DMV visit. -
Gather Your Documents:
You’ll need to bring:- Proof of identity (like a passport)
- Proof of legal presence (visa, green card, or other documents)
- Two documents showing you live in North Carolina (like a lease or utility bill)
- Social Security card (if you have one)
- Current driver’s license (if you’re exchanging from another state)
- Pass the Tests and Pay Fees:
You must pass a written test, a road test, and a vision test. Fees vary depending on the type of license.
REAL ID: What’s Changing in 2025?
Starting May 7, 2025, you’ll need a REAL ID-compliant driver’s license or ID card to board commercial flights or enter certain federal buildings. A REAL ID has a star in the corner. To get one, you must apply in person and show extra documents to prove your identity and legal status.
- REAL ID is not required for driving, voting, or getting federal benefits.
- Licenses without the star will say “Not for Federal Purposes” and will not be accepted for flights or federal buildings after May 7, 2025.
For more details, visit the North Carolina DMV REAL ID page.
New Laws and Restrictions: What’s on the Horizon?
North Carolina lawmakers are considering new rules that could affect non-citizens, especially those without legal status.
Senate Bill 153: What Does It Mean?
On March 4, 2025, the North Carolina Senate passed Senate Bill 153 (SB 153). This bill would:
- Require state and local police to work more closely with U.S. Immigration and Customs Enforcement (ICE)
- Investigate how public benefits are used, to find out if undocumented immigrants are getting benefits they shouldn’t
- Stop certain universities from becoming “sanctuary campuses” that limit cooperation with immigration authorities
As of April 21, 2025, SB 153 is waiting for a vote in the State House of Representatives. The bill has sparked protests from immigrant communities and groups like the ACLU of North Carolina, who say it could make life harder for immigrants and encourage discrimination.
If SB 153 becomes law, it could lead to:
- More checks on people’s immigration status when they apply for public benefits
- Increased fear among immigrant families about using health or social services
- Tighter rules for colleges and universities that want to protect undocumented students
Federal vs. State Rules
Immigration is mostly controlled by the federal government. States like North Carolina can decide how to handle some benefits, but they must follow federal laws. For example, the federal REAL ID Act of 2005 sets the rules for IDs used for flights and federal buildings, and North Carolina is enforcing these rules starting in May 2025.
What Does This Mean for Non-Citizens in North Carolina?
Let’s break down the main benefits and restrictions for non-citizens in North Carolina as of 2025:
| Area | Benefits/Eligibility for Non-Citizens | Restrictions/Requirements |
|---|---|---|
| Healthcare | Emergency Medicaid for all; full Medicaid for qualified immigrants with income limits; some children/pregnant women eligible | Undocumented immigrants not eligible for full Medicaid; 5-year waiting period for many immigrants |
| Driver’s License | Eligible to apply; REAL ID required for federal travel after May 7, 2025 | Must prove legal presence and residency; DMV requires immigration check-in for students/scholars |
| Public Benefits | Some state benefits may be available depending on immigration status | SB 153 may increase scrutiny and enforcement on benefits usage by undocumented immigrants |
| Travel & ID | REAL ID or passport required for commercial flights and federal building access | Licenses without REAL ID star not accepted for federal purposes after May 7, 2025 |
Real-Life Example
Consider Maria, an international student at a North Carolina university. She has a valid student visa and lives off-campus. Maria can apply for a driver’s license after completing her school’s immigration check-in and updating her SEVIS record. She brings her passport, visa, proof of address, and Social Security card to the DMV. Maria passes the tests and gets her license. If she wants to fly home for the holidays after May 7, 2025, she must have a REAL ID or use her passport at the airport.
Now think about Carlos, who is undocumented and works in construction. Carlos cannot get full Medicaid, but if he has a medical emergency, he can get help through emergency Medicaid. If SB 153 becomes law, Carlos may worry about applying for any public benefits, even those his children qualify for, because of increased checks and fear of being reported to immigration authorities.
Stakeholders: Who’s Involved?
Several groups play a role in shaping and enforcing these rules:
- North Carolina Department of Health and Human Services (NCDHHS): Decides who gets Medicaid and other health benefits.
- North Carolina Division of Motor Vehicles (NCDMV): Handles driver’s licenses and REAL ID cards.
- American Civil Liberties Union (ACLU) of North Carolina: Fights against laws they believe are unfair to immigrants, like SB 153.
- Center for Immigration Services & Support: Helps international students and scholars with immigration paperwork and DMV check-ins.
What’s Next? Looking Ahead to 2025 and Beyond
Several changes are on the horizon for non-citizens in North Carolina:
- SB 153 could become law, leading to more checks on immigration status and stricter rules for public benefits and university campuses.
- REAL ID enforcement starts May 7, 2025, making it essential for non-citizens to get the right ID if they want to fly or enter federal buildings.
- Medicaid expansion has made it easier for some qualified immigrants to get health coverage, but undocumented immigrants are still left out except for emergencies.
- Advocacy groups are watching these changes closely and may challenge new laws in court if they believe they violate rights or encourage discrimination.
Practical Tips for Non-Citizens in North Carolina
If you are a non-citizen living in North Carolina, here’s what you can do:
- Check your eligibility for Medicaid and other health programs by contacting NCDHHS or visiting their official website.
- Prepare your documents before applying for a driver’s license or REAL ID. Make sure your immigration status is up to date and your SEVIS record is current if you are a student.
- Stay informed about new laws like SB 153. Follow updates from trusted sources such as the ACLU of North Carolina or your local immigrant support group.
- Ask for help if you’re unsure about your rights or how to apply for benefits. Many universities and community organizations offer free legal advice and support.
Where to Get More Information
- North Carolina Department of Health and Human Services (NCDHHS):
medicaid.ncdhhs.gov | (919) 855-4100 -
North Carolina DMV REAL ID Information:
ncdot.gov/dmv/license-id/nc-real-id | (919) 715-7000 -
ACLU of North Carolina:
acluofnorthcarolina.org | (919) 834-3466 -
Center for Immigration Services & Support (Wake Forest University example):
iss.wfu.edu/license-id
As reported by VisaVerge.com, staying up to date with these rules is essential for non-citizens in North Carolina, especially as new laws and requirements take effect in 2025. By understanding your rights and preparing the right documents, you can avoid problems and make the most of the benefits available to you.
Final Thoughts
North Carolina’s rules for non-citizens are changing, especially in areas like healthcare and driver’s licenses. While some benefits are available to those with legal status, undocumented immigrants face more restrictions and uncertainty. The upcoming enforcement of REAL ID and the possible passage of SB 153 could make things even more complicated.
If you are a non-citizen in North Carolina, take action now: gather your documents, check your eligibility for programs, and stay informed about new laws. Reach out to official agencies or trusted organizations for help. By being prepared, you can protect your rights and access the services you need in 2025 and beyond.
Learn Today
Medicaid → A government health insurance program for low-income eligible residents based on income and immigration status rules.
Qualified immigration status → Legal permission to live in the U.S., including green card holders, refugees, and asylees.
Emergency Medicaid → Medical assistance for urgent care available regardless of immigration status, excluding routine treatments.
REAL ID → A federally compliant driver’s license or ID card required after May 7, 2025 for flights and federal access.
Senate Bill 153 (SB 153) → A proposed North Carolina law to increase collaboration between police and ICE on immigration enforcement.
This Article in a Nutshell
In 2025, North Carolina updates rules for non-citizens on Medicaid, driver’s licenses, and public benefits amid new immigration enforcement proposals.
— By VisaVerge.com
