How To Know if You Lost Medicaid

In general, you should receive a notice from your state’s Medicaid agency if your coverage has been terminated due to Medicaid cuts or a change in your eligibility status. It may be worth double-checking if the cancellation was simply the result of a clerical error and you can reapply — but if you are no longer eligible for Medicaid, you should look into alternative health insurance options, such as Medicare or a Health Insurance Marketplace plan.

Read on to learn more about how to know if you lost Medicaid coverage and what steps you need to take after losing Medicaid.

On This Page

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  How Do You Know if You've Been Disenrolled From Medicaid?

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  What Should You Do if You Lose Medicaid Coverage?

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  FAQs

How Do You Know if You've Been Disenrolled From Medicaid?

Medicaid will generally contact you by mail if there are any changes to your health insurance coverage, including if you have been disenrolled. For this reason, it’s crucial to make sure your state’s Medicaid agency has your updated contact information — especially if you move to a different address — so you won’t have to worry about missing any critical updates.^[1]

If you know your state’s Medicaid eligibility requirements, you may be able to figure out in advance whether your coverage will be dropped. For example, most states set the maximum income for Medicaid recipients at 138% of the federal poverty level (FPL), which is $21,957 for a single-person household.^[2][3] As a result, if you live by yourself and currently make $21,000 per year, you may lose your expanded Medicaid coverage after getting a $1,000 raise.

Keep in mind that the FPL depends on the number of people in your household. For example, an annual income of $35,000 falls under the 138% threshold for a family of three. However, in the event that you become a two-person household — like if your child graduates from college and moves out — your household income would then exceed the 138% threshold, meaning you may become ineligible for Medicaid even without experiencing a change in income.^[3]

What Should You Do if You Lose Medicaid Coverage?

If you receive a notice that you are about to lose your Medicaid health coverage, you should take the following steps to make sure you and your family members are sufficiently insured.

Contact Your Local Medicaid Agency

After learning that your Medicaid coverage has been canceled, your first step should be to get in touch with your state’s Medicaid program. If you simply failed to fill out a required renewal form, you may be able to get your coverage reinstated — as long as it has been less than 90 days since your coverage expired. In this scenario, your renewed coverage will retroactively apply beginning on the day you were initially disenrolled.^[4]

Your Medicaid coverage may also end if your local agency determines you are no longer eligible, but you can file an appeal if you believe your coverage has been canceled in error.^[4]

Reapply if You're Still Eligible

Even if it’s determined that you are still eligible for Medicaid, you may need to fill out a new application form if it has been more than 90 days since your plan was terminated.^[4] You can reapply for Medicaid through the federal Health Insurance Marketplace website or your state’s dedicated Medicaid website. Eligible applicants can sign up for Medicaid at any time, so you won’t have to worry about meeting any specific enrollment deadlines.^[5]

Explore the ACA Marketplace

If you don’t qualify for Medicaid anymore, you may still be able to secure affordable health insurance coverage through the Marketplace. The federal government offers income-based subsidies to help lower premiums for individuals who purchase private Marketplace plans. Most shoppers are eligible for subsidies, with 80% of enrollees paying less than $10 per month for Affordable Care Act (ACA) Marketplace coverage.^[6]

You can browse Marketplace plans on HealthCare.gov or your state’s equivalent health insurance exchange.

If you expect to lose coverage from Medicaid, you can enroll in a new Marketplace health insurance plan up to 60 days before your Medicaid coverage ends. Meanwhile, you can freely sign up for Marketplace health insurance for up to 90 days after losing Medicaid, and your new plan will take effect at the beginning of the month after you enroll.^[7]

Check for Special Enrollment Periods

While Marketplace enrollment isn’t open all the time, you’ll qualify for a special enrollment period (SEP) after losing your existing health insurance, including Medicaid. However, if you don’t buy a Marketplace plan before your 90-day SEP expires, you can’t try to enroll again until the next open enrollment period — which lasts from Nov. 1 to Jan. 15 in most states — unless you qualify for another SEP due to a qualifying life event, like getting married or giving birth.^[8][9]

Look Into Alternative Options

Depending on your circumstances, there are other options besides Marketplace insurance that may make sense for you after a Medicaid coverage loss. For example, you should qualify for Medicare if you are over the age of 65 or have a disability, permanent kidney failure or Lou Gehrig’s disease.^[10] You won’t even have to pay for Medicare Part A if you or your spouse worked and paid Medicare taxes for at least 10 years.^[11]

If you or your spouse has a full-time job, you may also qualify for group health insurance coverage through an employer. On average, businesses cover around 70% to 80% of the premiums for their employees’ health plans — depending on whether the plan provides family or individual coverage — so it will generally be much cheaper to get a plan through work than to purchase the same plan on your own.^[12][13]

Finally, you may want to consider short-term health insurance if you simply need to fill a temporary coverage gap, like if you will qualify for job-based coverage in one month but want to make sure you’re covered in case an unexpected accident occurs before then. However, short-term health insurance does not meet the same minimum essential coverage requirements as standard health insurance, so you shouldn’t treat it like a permanent solution.

See if Your Children Are Eligible for CHIP

Even if your income is too high for the adults in your household to qualify for Medicaid, your dependent children may still be eligible for free or low-cost coverage through the Children’s Health Insurance Program (CHIP). Depending on the state, children in families with household incomes as high as 400% of the FPL may qualify for CHIP.^[14] This comes out to $106,600 per year for a family of three.^[3]