The reason why she is getting this letter is because the Medicaid extension to people during the Public Health Emergency (PHE) has ended and everybody has to reapply for the coverage which they now can get based on the post- (PHE) new eligibility rules ( actually just the old rules coming back into play). This is the way NC has decided to do it - like the letter says - answer the questions on the Marketplace application truthfully and it sounds like she will be signed up for Medicaid.
The Health Insurance Marketplace in NC is the Federal Facilitated Marketplace for Healthcare coverage (Obamacare). In NC it is the place that people who want healthcare coverage with a subsidy, that don’t have other coverage, if they qualify, can find such a plan.
ALL of # 4 in the letter is important for application for Medicaid.
Talk to your social worker if you (or wife) need help in getting this done ASAP.
It's Always Something . . . . Roseanna Roseannadanna