State Profile · Deep
NORTH CAROLINA
C+Last verified 2026-07-03
Deadlines reflect this state’s rules as researched; they can change — always confirm the current deadline with your state agency or Protection & Advocacy office before relying on it.
HOW TO GET SERVICES & APPEAL IN NORTH CAROLINA
How services are run
Managed care organizations
Your service plan
Individualized Service Plan (ISP)
Self-direction
Community Living and Supports (self-direction)
If you get denied
Deadline to appeal
30 days from your Notice of Adverse Determination (FFS) / Notice of Resolution (managed-care MCE appeal)
- Fee-for-service Medicaid service denial: file appeal request with OAH within 30 days of notice mailing
- Managed care (Standard Plans / I-DD Tailored Plans): file MCE internal appeal within 60 days of notice
- After MCE Notice of Resolution: file contested case with OAH within 120 days
- Continuation: request hearing before the effective date of the adverse determination (notice mailed at least 10 days prior)
KEY AGENCIES & RESOURCES
Early Intervention (Part C)
NC Infant-Toddler Program (Children's Developmental Services Agencies)
Aging & Disability Resource Center
North Carolina ADRC / Aging and Disability Resource Center
NOTABLE WAIVERS
NC Innovations Waiver
SourceChildren and adults with intellectual/developmental disabilities.
Waitlist: Registry of Unmet Needs exceeds 16,000 — register the day you have a diagnosis.
CAP/C (Community Alternatives Program for Children)
SourceMedically fragile children under 21.
Waitlist: Apply through NC Medicaid; assessment-based.
CAP/DA (Community Alternatives Program for Disabled Adults)
SourceAdults with disabilities needing nursing-level in-home care.
Waitlist: County-level capacity; verify locally.
TBI Waiver
SourceAdults with traumatic brain injury (select regions).
Waitlist: Regional pilot; verify with your LME/MCO.
