Are You One of the Millions About To Lose Medicaid?

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Under COVID-related guidelines, five million Americans have been relying on Medicaid as their primary form of insurance. Starting April 1,2023, emergency health insurance protections that were put into place during the COVID pandemic will end. Roughly 15 million people – that is 1 in 6 Americans – will lose Medicaid coverage. In order to remain insured, they must fill out an application, stating their address, income and household size but they may make too much money to be eligible.

The pandemic guidelines that allowed people making more money than original Medicaid eligibility guidelines will slowly unwind in every state, also affecting those who moved out of state or had health insurance access through an employer. 

If you’re one of these people, we have some tips on finding an insurer that matches your needs and budget. You may be eligible for Obamacare plans, even if your salary is higher than Medicaid maximums. If you don’t qualify for a subsidized plan in the marketplace, there are affordable private plans to choose from.

Not all private health insurance plans are exorbitantly priced. However, we recommend that you compare health insurance quotes before you buy. And before you compare quotes, you must understand your coverages.

Key Takeaways

  • 15 million people, including children, will soon lose Medicaid coverage and need to buy health insurance.
  • The cheapest plan may end up costing you more if you have a pre-existing condition or see specialists regularly.
  • There is a cap to how much you spend on health insurance in a year (a deductible) if you buy a health insurance plan.
  • The cheapest health insurance policies (bronze) have a high deductible and are designed for young, healthy individuals who rarely need medical care.

Who Is Losing Medicaid Coverage?

Some states have already started disenrolling Medicaid recipients. Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma and West Virginia are scheduled to unwind enrollment beginning in April. Here is when you should expect it to affect you:

US map showing States that have started disenrolling Medicaid recipients

April May June July Oct
Arizona Connecticut Alabama California Oregon
Idaho Florida Alaska Delaware  
New Hampshire Indiana Colorado Illinois  
South Dakota Iowa DC Louisiana  
  Kansas Georgia Michigan  
  Nebraska Hawaii Minnesota  
  New Mexico Kentucky Missouri  
  Ohio Maine New York  
  Oklahoma Maryland North Carolina  
  Pennsylvania Massachusetts    
  Utah Mississippi    
  Virginia Montana    
  West Virginia Nevada    
  Wyoming New Jersey    
    North Dakota    
    Rhode Island    
    South Carolina    

Will My Children Lose Coverage Too?

Yes, if your household income reaches Medicaid thresholds, your children will lose health insurance unless you cover them under your health insurance plan. You will be contacted by Medicaid in your state by phone, text message or email to remind you to fill out the application to see if you’re still eligible.

Make sure to fill out the form, or else you will lose coverage even if you still qualify for Medicaid.

Your children will lose health insurance unless you cover them under a new health insurance plan.

How Can I Find a Health Insurance Plan That Fits My Budget?

If you don’t qualify for Medicaid or a subsidized health insurance plan in your state’s health insurance marketplace, you’ll want to shop around and compare rates from many health insurance companies to find the coverage you want at the lowest price.

Compare Health Insurance Quotes and Save

Which Type of Health Insurance Offers the Most Savings?

High-deductible Health Plan (HDHP): Low premiums, high deductibles and out-of-pocket limits. Great plan if you're young and healthy but want a limit to your expenses if you have a sudden and unforeseen medical emergency. Also called catastrophic health plans, they are not recommended for people with existing conditions or those who see many specialists.

Health Maintenance Organization (HMO): This is a popular form of health insurance plan. HMOs are cheaper than other policies but only if you visit in-network doctors. Preventive care is often free and copays are low so you pay very little out-of-pocket if anything at all.

Preferred Provider Organization (PPO): The convenience of PPO plans is that you are free to go to doctors and hospitals outside your network, but may be 100% covered if you use in-network providers.

Exclusive Provider Organization (EPO): If you travel for work or just travel very much in general some health insurance companies offer EPOs which are just like HMOs but with a wider geographic network of doctors to cover a wide geographic area.

Point of Service Plan (POS): These types of plans are harder to find and are often expensive. You pay for services upfront and then submit receipts from doctors visits for reimbursement as coverage.

How Do I Choose the Health Insurance Plan Tier?

Not all private health insurance plans are unaffordable. It all depends on your needs and where you live. Many people opt for private health insurance over what their employer offers as well, if they want superior coverage or simply more privacy.

If you’re on a budget, you should at least have a low premium (monthly payment) with a high deductible plan (called a “bronze plan”). Although coverage won’t be comprehensive, you’ll be protected in case something happens and your health is compromised. There is a maximum out-of-pocket cost with these plans, so say you need surgery – you won’t have to pay thousands of dollars out-of-pocket. If you’re young and very healthy, this plan will be adequate and very affordable.

If you can afford it, most Americans have at least a “silver plan,” which is one tier up from the high-deductible plan. It offers more coverage and a wider network of providers. You may have to give up a doctor you’ve been seeing if they are not in the network or else you’ll pay considerably more for services rendered by that physician.

If you have an existing condition and regularly see specialists and need many prescription medications, it’s advisable to consider a gold or platinum plan, even though they cost more monthly. Your out-of-pocket savings will outweigh the hike in premiums.

Whatever you do, do not risk financial bankruptcy due an unexpected ailment, injury or surgery. Get coverage as soon as you know you’re losing your Medicaid coverage.

If you don’t qualify for Medicaid or a subsidized health insurance plan, you’ll want to shop around and compare rates.

Losing Medicaid Coverage FAQs

What is my maximum out-of-pocket costs if I buy health insurance?

The maximum out- of-pocket expense limit is $9,100 in 2023. This means that you cannot be charged copays and deductibles once you reach the limit. Your insurer is responsible to pay for all costs thereafter.

What is the Poverty Level in 2023?

For individuals, the poverty level is $13,590. For a family of four it is $27,750. People with poverty-level incomes may be able to get a subsidized health insurance plan. All premium assistance subsidies are income-based.

Is there a tax penalty for not having health insurance in 2023?

There is a tax penalty for not having health insurance in five states: Massachusetts, California, Rhode Island, New Jersey and Vermont.

You may be eligible for an affordable plan so don’t put off buying coverage until something terrible happens because it’ll be too late and much more expensive than paying a monthly premium.

SmartFinancial can help you find the right plan if you want to shop online by entering your zip code here or by calling 855.214.2291 to be in touch with a knowledgeable agent who can guide you through the health insurance buying process.


  1. Medicaid, accessed March 31, 2023.
  2. SmartFinancial Blog Articles, accessed March 31, 2023.

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