Medicaid Program Renewal: What You Need to Know

The most important step you can take right now is to confirm that your state Medicaid office has your current mailing address, phone number, and email.

If you’ve moved, changed phone numbers, or switched email addresses in the past few years, update your information immediately. States often mail renewal notices or text reminders—and if you don’t receive them, you may lose your coverage even if you’re still eligible.

Checklist:

• Call your state Medicaid office or visit its website.

• Confirm your address, phone number, and email.

• Ask when your renewal date is and how they’ll contact you.

Once your contact information is up to date, the next step is to watch for renewal notices and respond right away to avoid any lapse in coverage.

Watch your mail and messages

States must send renewal notices and provide a minimum of 30 days for enrollees to respond before coverage ends. However, some states may send notices as far out as 60 days prior.

As soon as you receive anything related to your Medicaid renewal, open it, fill it out, and return it right away. Even if nothing has changed with your income or family situation, you still need to confirm your information.

If you miss the deadline

If your coverage ends because you missed a renewal form or other paperwork, contact your state agency right away. Federal rules give you a 90-day window to turn in late forms and have your coverage reinstated if you’re still eligible.

Act fast — the sooner you respond, the easier it is to stay insured.

Use your Special Enrollment Period

If you lose Medicaid because your income increased or you’re no longer eligible, you may qualify for a Special Enrollment Period to get health insurance through the HealthCare.gov Marketplace.

Typically, you can apply and enroll up to 60 days before your Medicaid or CHIP coverage ends to avoid a gap, or within 90 days after your coverage ends to start a new plan. Most Marketplace plans include subsidies, known as premium tax credits. Think of these as federal discounts that lower your monthly premium based on your income.

Example: How Premium Tax Credits Lower Your Costs

Here’s what this looks like:

• Brandi, age 34, earns $29,000 a year. Her plan costs $596/month, but a $547 tax credit lowers her payment to about $49/month.

• Becca, age 25, earns $20,000 a year. Her plan costs $362/month, and a $362 tax credit covers the full amount—she pays $0.

If your Medicaid coverage ends before your new plan begins, don’t skip care. You can still get affordable medical help.

Federally Qualified Health Centers (FQHCs)

These are community clinics that provide medical, dental, and behavioral health care to individuals regardless of their insurance status. Fees are based on your income, and no one is turned away for inability to pay.

WorkMoney’s Low-Cost Healthcare Provider Finder can help you locate an FQHC or similar clinic in your area. This is care you’ve earned access to—it exists to make sure no one goes without help during a transition.

Stride

You can use Stride to help you compare providers and find the best healthcare plan for you and your family. Get started here.

Even with insurance, medical bills can pile up—especially if you’ve lost coverage or had an unexpected hospital stay. The good news is that you may qualify for charity care, which could reduce or even eliminate your debt.

Most nonprofit hospitals are legally required by the IRS to offer financial assistance or charity care programs that provide free or discounted services for eligible patients.

Fortunately, you don’t have to face hospital bills alone.  DollarFor helps you apply for financial assistance and guides you through the process—for free.

For example, if you received a $4,000 hospital bill after losing Medicaid, Dollar For can check if you qualify and help you submit your application at no cost.

If your Medicaid coverage ended and you didn’t act in time, contact your state Medicaid office right away. You may be able to:

• Reapply or submit missing paperwork within 90 days.

• Request a fair hearing to appeal if you think your coverage was wrongly terminated.

• Use your Special Enrollment Period to get a new ACA plan.

Tip: Even if your Medicaid was canceled, you can retroactively enroll in Marketplace coverage starting the day after your Medicaid ended, as long as it’s within 60 days.