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Income and Social Security
North Carolina SSI supplement
North Carolina's state supplement, State/County Special Assistance, is a monthly cash payment that helps people 65 or older with low income pay for room and board in an adult care home, family care home or group home.
A smaller In-Home program helps some people who need that level of care stay in their own homes. People who get Special Assistance also get Medicaid.
How to apply in North Carolina
- In person
- Your county Department of Social Services
Who may qualify in North Carolina
| Age | 65 or older, or 18 to 64 and disabled |
|---|---|
| Care need | A health care provider must verify that you need residential facility level of care |
| Residency | North Carolina resident, U.S. citizen or qualified non-citizen |
Source: North Carolina Department of Health and Human Services (source 3)
What you may get
| Monthly supplement, one person living on their own (2026) | None for most people living on their own. The In-Home program may help if you need facility-level care but stay at home |
|---|---|
| Monthly Special Assistance payment, adult care home (2026) | The $1,467 maintenance amount (the $1,397 maximum rate plus $70 for personal needs) minus your countable income |
| Most an adult care home can charge a Special Assistance resident for room and board (2026) | $1,397 a month |
| Maximum rate, special care unit for Alzheimer's or related disorders (2026) | $1,792 a month |
| Maximum Special Assistance In-Home rate (2026) | $1,397 a month basic; $1,792 enhanced for Alzheimer's disease or dementia |
| Personal needs allowance added to the rate | $70 a month |
Source: North Carolina Department of Health and Human Services (source 2)
Dates, renewals and waiting lists
| How long a decision may take | Up to 45 days if you are 65 or older |
|---|---|
| When rates change | Each year, with the Social Security cost-of-living change (since January 2023) |
Source: North Carolina Department of Health and Human Services (source 3)
How North Carolina is different
Where North Carolina's rules differ from the federal rules for State SSI supplements.
- Paid separately by the state; apply with your county Department of Social Services
- If you get Special Assistance, you are automatically eligible for Medicaid
Source: North Carolina Department of Health and Human Services (source 1)
Good to know
- The facility must be approved for Special Assistance and agree to accept the state rate.
Source: North Carolina Department of Health and Human Services (source 1)
Free help
Free help with this in North Carolina
More help in North Carolina
State SSI supplement in another state
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kentucky
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
Sources
- North Carolina Department of Health and Human Services, State and County Special Assistance for Adult Care Home Residents (official government site). Checked Oct 28, 2026.
- North Carolina Department of Health and Human Services, State and County Special Assistance for In Home Residents (official government site). Checked Oct 28, 2026.
- North Carolina Department of Health and Human Services, The State/County Special Assistance Program: Adult Care Home brochure (12/2025) (official government site). Checked Oct 28, 2026.
- North Carolina Department of Health and Human Services, Special Assistance Special Care Unit brochure (2026) (official government site). Checked Oct 28, 2026.
- North Carolina Department of Health and Human Services, The State/County Special Assistance In-Home Program for Adults brochure (12/2025) (official government site). Checked Oct 28, 2026.
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