Here’s what to do if you get a notice that your Medicaid coverage is ending. The first step is to find out why.

Medicaid provides healthcare coverage to more than 72 million Americans with low incomes. Getting notice that your coverage is ending can send you looking for answers — and alternative healthcare coverage.

In response to COVID-19, the federal government provided additional Medicaid funding to prevent people on the program from losing healthcare coverage. But now that this additional funding has ended, millions of people may lose Medicaid benefits or have to re-enroll between now and mid-2025.

Here’s what to do if you receive a notice about your coverage ending.

Both federal and state governments fund Medicaid. But each state sets its own eligibility rules. If your state determines that your household income is higher than the eligibility limit or if other factors mean that you no longer qualify, you may lose your Medicaid coverage.

For example, if you get a temporary boost in income, such as through seasonal employment or an inheritance, you might become ineligible for Medicaid.

Other reasons you might lose your Medicaid coverage include:

  • a move out of state
  • pregnancy or parenting status change
  • family status change, like getting married
  • a change in disability status
  • turning 26 and aging out of foster care eligibility

If you’re unsure whether you still qualify for Medicaid benefits, this online tool can give you a quick assessment.

That said, your state’s Medicaid agency is required to notify you of any changes to your coverage. This usually happens by mail, so it’s important to update the agency if you’ve moved, as well as complete and submit any requested forms promptly to ensure continued coverage.

If you have questions about renewal or losing your coverage, you can also contact your state agency for answers. When you call, have eligibility information handy. You might also need to verify your address, number of people in the household, and household income.

Navigating insurance and care in the healthcare system can be confusing, but help is available. Here are some tips for what to do if you’re denied Medicaid.

Speak with a healthcare advocate

Healthcare advocates work for medical centers, senior living facilities, and health insurance companies. They can help you:

  • review charges
  • negotiate payments
  • find assistance programs
  • explain policy terms
  • maximize health plan benefits
  • inform you of your rights
  • schedule visits and arrange transportation
  • choose the right insurance product.

Keep in mind that a healthcare advocate’s loyalty may lie with their employer, whether it’s a healthcare system or an insurance company. You can also hire your own patient advocate, which you can find using one of the following directories:

Consider possible tax deductions

The government offers a little extra help for individuals or families with high healthcare expenses. If the cost of qualifying medical and mental healthcare adds up to more than 7.5% of your adjusted gross income, you can deduct those expenses from federal taxes.

This includes the cost of care and supplies for dependents. Make sure to keep receipts for the expenses and talk with a tax preparer for more information.

Appeal the decision

If you disagree with a Medicaid program’s decision, you have the right to appeal. To appeal a decision, follow your state’s process. The appeal has to be filed in a timely manner. For some states, the window is as short as 20 days. Other states may allow up to 90 days.

Some states require that requests for appeals hearings be made in writing and either mailed, faxed, or hand-delivered. You might be able to request that your Medicaid coverage remain in place during the appeal process, but make sure to make the request before the date coverage is set to expire.

To help someone navigate their Medicaid renewal, help them reach out to their state agency to make sure it has the correct address, phone number, and email on file.

Help them contact the agency if they haven’t received any letters about their coverage status. If they did receive a letter, you can support them by reading it carefully for any important information, such as their current coverage status and if they need to fill out a renewal form. If a renewal form is necessary, help them send it back by the deadline to avoid any gaps in coverage.

If they already lost coverage because they didn’t send back the renewal form, they may still be able to restore it within the 90-day reconsideration period.

If they lost coverage for other reasons, discuss their other options with them, such as a health plan through the Health Insurance Marketplace.

If you’re no longer eligible for Medicaid health coverage, you may have other options. But don’t delay. Some options come with limited enrollment periods:

  • ACA plans for people under 65: You can check healthcare.gov for Affordable Care Act (ACA) plans available in your area and apply within 60 days of the date Medicaid coverage was lost.
  • Medicare for people over 65: If you’re 65 or older, you may qualify for Medicare. You have 3 months from the date Medicaid coverage ends to enroll in a Medicare plan.
  • Plans for residents of New York, Oregon, or Minnesota: Residents of these states can apply for a basic health program for people whose income sometimes disqualifies them from Medicaid.
  • Short-term health plans: These plans bridge the gap between losing Medicaid coverage and regaining it, access to Medicare, or an employer’s health plan. Rules for short-term health plans vary by state.
  • Community health centers: People without health insurance can get reduced-price medical care at community health centers. Find one near you at nachc.org or find free and charitable clinics at nafcclinics.org.
  • Emergency departments: Emergency departments are required to stabilize people regardless of their ability to pay. Many hospitals also provide free or reduced-price care to people who cannot pay. Ask your hospital about charity care if you need help paying for services.

Can you lose your Medicare coverage?

Unlike Medicaid, which is managed on a state level, Medicare is a federal program. If you qualify based on age, you can’t lose Medicare. You may also qualify if you’re younger and are living with certain conditions. In theory, you could lose Medicare if you recover from such a condition and you don’t have another qualifying condition. In addition, you could lose coverage if you don’t pay your plan’s premium.

How many Americans have been disenrolled from Medicaid?

During the COVID-19 pandemic, the public health emergency (PHE) provision protected your Medicaid coverage. Since it has been lifted, Medicaid has been conducting annual reviews of coverage, and over 25 million people have lost their Medicaid coverage, according to a recent analysis of data.

What is the lowest income to qualify for Medicaid?

To qualify for Medicaid, your yearly income must be below a certain amount, and you must have a certain number of family members. This may vary by state, but it’s generally around 133% of the Federal Poverty Level (FPL). In 2024, this is about $25,820 for a family of three or $15,060 for an individual.

Medicaid provides healthcare coverage to millions of Americans. But if you lose eligibility, you have options. A few basic steps can help you get the healthcare you need and deserve.