Medicaid renewal: how it works and what to do if coverage ends
Medicaid renewal is your state's regular check that you still qualify. The state first tries to renew you with records it already has. If it can't, it mails you a form. Most people get at least 30 days to return it. From 2027, most adults covered through Medicaid expansion will renew every six months.
Apply for free on your state's official site
Medicaid and CHIP applications are free, and you can apply any time of year. Apply directly with your state Medicaid agency, or through HealthCare.gov if your state uses it.
All states: Medicaid agency websites
- Alabama: Alabama Medicaid (medicaid.alabama.gov)
- Alaska: Alaska Medicaid (health.alaska.gov)
- Arizona: Arizona Health Care Cost Containment System (AHCCCS) (azahcccs.gov)
- Arkansas: Arkansas Medicaid (humanservices.arkansas.gov)
- California: Department of Health Care Services (Medi-Cal) (dhcs.ca.gov)
- Colorado: Health First Colorado (healthfirstcolorado.com)
- Connecticut: Connecticut Medicaid (HUSKY) (portal.ct.gov)
- Delaware: Delaware Medicaid & Medical Assistance (dhss.delaware.gov)
- District of Columbia: DC Medicaid (districtdirect.dc.gov)
- Florida: Florida Agency for Health Care Administration (ahca.myflorida.com)
- Georgia: Georgia Medicaid (dch.georgia.gov)
- Hawaii: Hawaii Med-QUEST Division (medquest.hawaii.gov)
- Idaho: Idaho Department of Health & Welfare (healthandwelfare.idaho.gov)
- Illinois: Illinois Department of Healthcare and Family Services (hfs.illinois.gov)
- Indiana: Indiana Family and Social Services Administration (in.gov)
- Iowa: Iowa Department of Human Services (hhs.iowa.gov)
- Kansas: KanCare (kancare.ks.gov)
- Kentucky: Kentucky Cabinet for Health and Family Services (Kynect) (chfs.ky.gov)
- Louisiana: Healthy Louisiana (ldh.la.gov)
- Maine: Maine Department of Health and Human Services (MaineCare) (maine.gov)
- Maryland: Maryland Department of Health (health.maryland.gov)
- Massachusetts: MassHealth (mass.gov)
- Michigan: Michigan Department of Health & Human Services (michigan.gov)
- Minnesota: Minnesota Department of Human Services (mn.gov)
- Mississippi: Mississippi Division of Medicaid (medicaid.ms.gov)
- Missouri: Missouri Department of Social Services (dss.mo.gov)
- Montana: Montana Department of Public Health and Human Services (dphhs.mt.gov)
- Nebraska: Nebraska Department of Health and Human Services (dhhs.ne.gov)
- Nevada: Nevada Department of Health and Human Services (dhhs.nv.gov)
- New Hampshire: New Hampshire Department of Health and Human Services (dhhs.nh.gov)
- New Jersey: New Jersey Department of Human Services (state.nj.us)
- New Mexico: New Mexico Human Services Department (hsd.state.nm.us)
- New York: New York State Department of Health (health.ny.gov)
- North Carolina: North Carolina Medicaid (medicaid.ncdhhs.gov)
- North Dakota: North Dakota Department of Human Services (applyforhelp.nd.gov)
- Ohio: Ohio Department of Medicaid (medicaid.ohio.gov)
- Oklahoma: Oklahoma Health Care Authority (oklahoma.gov)
- Oregon: OregONEligibility (one.oregon.gov)
- Pennsylvania: Pennsylvania Department of Human Services (dhs.pa.gov)
- Rhode Island: Rhode Island Executive Office of Health and Human Services (eohhs.ri.gov)
- South Carolina: South Carolina Health Connections Medicaid (scdhhs.gov)
- South Dakota: South Dakota Department of Social Services (dss.sd.gov)
- Tennessee: Tennessee Department of Health (TennCare) (tn.gov)
- Texas: Texas Health and Human Services (hhs.texas.gov)
- Utah: Utah Department of Health Medicaid (medicaid.utah.gov)
- Vermont: Vermont Health Connect (portal.healthconnect.vermont.gov)
- Virginia: Virginia Department of Medical Assistance Services (dmas.virginia.gov)
- Washington: Washington State Health Care Authority (hca.wa.gov)
- West Virginia: West Virginia Department of Health and Human Resources (dhhr.wv.gov)
- Wisconsin: Wisconsin Department of Health Services (dhs.wisconsin.gov)
- Wyoming: Wyoming Department of Health (health.wyo.gov)
State agency links from Medicaid.gov's directory of state Medicaid agencies, checked October 19, 2026.
Your options, cheapest first
Renewing your Medicaid costs nothing. Many renewal problems can be fixed if you act early. Start at the top of this list and work down.
1. Renew on time
- Who qualifies
- Anyone with Medicaid who still meets their state's rules.
- What it costs
- Nothing to renew. Medicaid and CHIP are free or very low cost for people who qualify.
- How to get it
- Answer your renewal letter by its due date. For most people, states must take renewals online, by phone, by mail or in person.
2. Send a late form within 90 days
- Who qualifies
- People whose Medicaid ended because the renewal form or papers did not come back in time.
- What it costs
- Nothing.
- How to get it
- Send the form within 90 days after your coverage ended. For most people, the state must look at it again without a new application. Some states allow longer.
3. Ask for a fair hearing
- Who qualifies
- Anyone who gets a notice that ends or cuts their Medicaid and thinks it is wrong.
- What it costs
- Nothing to ask.
- How to get it
- Follow the steps on the notice. In most cases, asking before the change takes effect keeps your coverage while you wait.
4. Low-cost care while you sort it out
- Who qualifies
- Anyone, with or without coverage.
- What it costs
- Community health centers charge on a sliding scale based on income; some visits cost little or nothing.
- How to get it
- Search HRSA's Find a Health Center tool (findahealthcenter.hrsa.gov), then see how health center discounts work.
5. A Marketplace plan
- Who qualifies
- People who no longer qualify for Medicaid, for example after a raise.
- What it costs
- A monthly premium, which is the price you pay each month for a plan. Depending on your income, a tax credit can lower it. Read the work-requirement warning below first.
- How to get it
- Losing Medicaid can let you sign up outside the usual yearly sign-up season. Details are in the last section.
How Medicaid renewal works
Renewal is how your state checks that you still qualify for Medicaid. Some states call it a review or recertification. You may also see the word redetermination. That is the broader term. It covers renewals and any check the state does when you report a change, like a new job or a new baby (CMS letter to states, March 2026 (medicaid.gov)).
- The state checks its records first. It looks at data it can already get, such as wage records. If that shows you still qualify, it renews you and sends a notice. You don't have to send that notice back unless something on it is wrong.
- If it can't renew you that way, it mails a form. The form is filled in with what the state already knows. Fix anything that is wrong, sign it and send it back with any proof it asks for. If your Medicaid is based on income, you get at least 30 days to do this (42 CFR 435.916 (ecfr.gov)).
- The state decides. It should finish before your coverage period ends (CMS, SMD #26-001 (medicaid.gov)). Before it ends your coverage, it must check whether you qualify in another way. It must also send you a notice at least 10 days before the change (42 CFR 431.211 (ecfr.gov)). The notice must say what is changing, why, and how to appeal.
- The clock starts over. If you still qualify, you get a new coverage period. For most people it lasts 12 months. For many adults, it will be 6 months starting in 2027.
Between renewals, tell your state about changes that could affect your coverage. That includes income, address and who lives with you. If your Medicaid is based on income, the state can't make you come in for an interview to renew.
Most children, parents, pregnant people and expansion adults have Medicaid based on income. If you get Medicaid because of age, blindness or a disability, the state must still try its records first. It may use the same form and 30-day timeline, but federal rules don't require it to. A 2024 rule would have required that. A 2025 law put that part on hold until Sept. 30, 2034 (CMS bulletin, Nov. 18, 2025 (medicaid.gov)). Your letter gives your deadline.
What changes in 2027: six-month renewals
A 2025 federal law, Public Law 119-21 (often called H.R. 1), changes how often one large group renews. For renewals scheduled on or after Jan. 1, 2027, states must renew most expansion adults every six months instead of every 12. Expansion adults are people ages 19 to 64 who get Medicaid through the Affordable Care Act's expansion (CMS, SMD #26-001 (medicaid.gov)).
- Six months: most expansion adults. This only applies in states that cover this whole group.
- Still 12 months: people in other income-based groups, such as children, pregnant people, and parents in the parent and caretaker group. Certain American Indians and Alaska Natives in the expansion group also stay at 12 months.
- At least once a year: people who get Medicaid because of age, blindness or a disability.
How your state moves you to six months
CMS gave states two choices for expansion adults who already have Medicaid on Jan. 1, 2027:
- Move your date up. The state shortens your current period so your next renewal comes sooner. It can't start that renewal before Jan. 1, 2027. It also can't cut your period to less than 6 months. It must mail you a notice at least 10 days ahead, with appeal rights.
- Keep your date. You renew on the date already set for 2027. If you still qualify, your next period lasts 6 months.
Each state also picks how early to start a renewal. In CMS's examples, states start about 60 to 90 days before a period ends. Your letter and your state's renewal page (see the table below) tell you what applies to you.
Worked example: one person, two state choices
Say your 12-month coverage began Nov. 1, 2026, and was set to last to Oct. 31, 2027. CMS uses a case like this in its guidance.
- If your state moves the date up: your period now ends April 30, 2027. In CMS's example, the renewal starts March 1, 2027. If you still qualify, your next period is May 1 to Oct. 31, 2027. After that, you renew every 6 months.
- If your state keeps the date: your renewal starts on its usual schedule, a few months before Oct. 31, 2027. If you still qualify, your next period is Nov. 1, 2027, to April 30, 2028.
Either way, renewals will come about twice as often as before. Keep your address current so you don't miss it.
Work requirements are checked at renewal
Starting Jan. 1, 2027, many expansion adults must also show "community engagement" to keep Medicaid. A state can choose to start sooner. Community engagement means work, school, community service, a work program or enough monthly income. A mix of these can count too. Some people are exempt. Your state checks this at each renewal and must try its own data first. If it can't confirm you meet the rule, it must send a notice. You then get 30 days to show you meet the rule or are exempt. Your coverage continues during those 30 days (CMS bulletin, Dec. 8, 2025 (medicaid.gov)).
A state can ask for a temporary delay, but any delay must end by Dec. 31, 2028. For who must report and who is exempt, see FreedInsure's guide to 2027 work requirements.
Before you count on a Marketplace plan: say your state finds you would qualify for Medicaid except that you did not meet the work requirement. Federal law then treats you as eligible for Medicaid. That means you can't get the premium tax credit, the tax credit that lowers monthly prices for Marketplace plans (CMS bulletin, Dec. 8, 2025 (medicaid.gov)). If that is your situation, work on the problem with your state first. Use low-cost care in the meantime.
You got a renewal letter: what to do
Renewal mail looks different in each state. Under the federal rules above, it is usually one of three things:
- A notice that you're renewed. The state used its records. Read it anyway, and tell the state if anything is wrong.
- A renewal form. The state needs you to check it, sign it and send it back, often with proof. Look for the due date.
- A notice of decision. It says whether your coverage stays the same, changes or ends, and why. It also explains how to ask for a hearing (42 CFR 431.210 (ecfr.gov)).
Renewal letter checklist
- Not sure when your renewal is due? Many states show the date in your online account. You can also call your state Medicaid office.
- Find the due date on the letter. Put it on your calendar with a reminder a week before.
- Answer even if you think you no longer qualify. The state must check you for other groups, and for other coverage help if Medicaid ends.
- Check your name, address, phone number, household members and income on the form. Fix anything that is wrong.
- Gather only the proof the letter asks for. Common examples are recent pay stubs, a letter about your Social Security or jobless benefits, and records of income from your own business.
- Sign and date the form where it asks.
- Send it back one of the ways your letter lists: online account, phone, mail or in person.
- Keep proof that you sent it, such as a confirmation number, a screenshot, a copy or a mailing receipt.
- If you moved or got a new phone number, update your contact details with the state too.
- Once you're renewed, write down the end date of your new period. Your next renewal will start before that date.
What to say when you call your state
"Hi, I'm calling about my Medicaid renewal. My case number is ____. Did you get my renewal form and papers? Is anything missing? When does my coverage end, and when will you decide? Can you check that you have my right address and phone number?"
The number to call is on your letter. You can also find it through your state's page in the table below.
Where to renew Medicaid in your state
Each row links to the page where your state explains renewal, or to the online account where you can renew. Your own letter has the final word on your due date and the ways your state accepts.
What this means for you: most states let you renew through an online account, and most of these pages also list phone, mail and in-person options. Some states use two systems. In Connecticut, Maryland and New York, for example, people in some groups renew through the state's health insurance marketplace. Others renew through a state or local social services office. Your letter says which one is yours. If a link has moved, use the state list at the top of this page.
If your Medicaid is ending or has ended
Read your notice first. It must say what is changing, when, and why. Then work through these steps in order.
- If it ended over paperwork, send the renewal form and proof now. If you do this within 90 days after your coverage ended, the state must reconsider you without a new application. This rule covers people whose Medicaid is based on income. That includes most children, parents, pregnant people and expansion adults (42 CFR 435.916 (ecfr.gov)).
- If you think the decision is wrong, ask for a fair hearing. Your state sets the deadline, which can be up to 90 days from the date the notice was mailed (42 CFR 431.221 (ecfr.gov)). Ask before the change takes effect to keep your coverage during the appeal. If you lose the appeal, the state may ask you to repay the cost of care you got while you waited (42 CFR 431.230 (ecfr.gov)).
- If only some people in your home lost Medicaid, ask the state to check each child for CHIP. You can also learn about children's coverage at InsureKidsNow.gov.
- Get care at low cost while you sort it out. Health centers that get federal grants can't turn you away because you can't pay. They also lower fees based on income (42 CFR 51c.303 (law.cornell.edu)). Nonprofit hospitals must have a written financial assistance policy (IRS (irs.gov)). See how hospital charity care works and how free clinics work.
- Look at a Marketplace plan if you no longer qualify for Medicaid. The steps are in the next paragraph.
- Reapply when things change. You can apply for Medicaid any time of year (HealthCare.gov). For applications made on or after Jan. 1, 2027, Medicaid can cover care from up to 1 month before the month you apply if you are an expansion adult, or up to 2 months for others. Before, it was up to 3 months (CMS bulletin, Nov. 18, 2025 (medicaid.gov)). So it pays to apply soon after a change.
Losing Medicaid or CHIP can open a Special Enrollment Period. That is a chance to sign up for a Marketplace plan outside the yearly season. HealthCare.gov says you may qualify if you lost Medicaid or CHIP in the past 90 days (HealthCare.gov). If your state runs its own marketplace, check its rules through HealthCare.gov's list of state marketplaces. Depending on your income, a premium tax credit can lower your monthly premium. You can't get that credit if you lost Medicaid only because you did not meet the work requirement.
Open Enrollment for 2027 coverage begins Nov. 1, 2026. Check HealthCare.gov or your state's marketplace for your deadline.
Find it near you (official and nonprofit finders)
- HRSA Find a Health Center (findahealthcenter.hrsa.gov)Search by address or ZIP code; results list federally funded health centers by distance.
- NAFC Find a Free Clinic (nafcclinics.org)Search by city or ZIP code; call the clinic before you go, because hours and rules vary.
What "Medicaid unwinding" meant
In 2020, Congress required states to keep nearly everyone on Medicaid during the COVID-19 emergency. That rule, called continuous enrollment, ended March 31, 2023 (Medicaid.gov). States then had to renew everyone again. That restart was called the unwinding.
KFF tracked the results. As of Sept. 12, 2024, over 25 million people had been disenrolled. About 7 in 10 of them (69%) lost coverage over paperwork or other process problems. The state had not found them ineligible (KFF (kff.org)). The unwinding is over, and normal renewal rules apply again. Its lesson still holds: keep your address current and answer every letter.
Common questions
- How often do you have to renew Medicaid?
- Most people renew once every 12 months. For renewals scheduled on or after Jan. 1, 2027, most adults in the Medicaid expansion group renew every 6 months. People who get Medicaid because of age, blindness or a disability are renewed at least once a year.
- What happens if I don't send back my Medicaid renewal form?
- Your state can end your coverage after mailing you a notice at least 10 days ahead. If your Medicaid is based on income and you send the form within 90 days after it ends, the state must reconsider you without a new application. Some states allow longer.
- Can I renew Medicaid online?
- Usually, yes. If your Medicaid is based on income, your state must let you renew online, by phone, by mail or in person. Use the account named on your letter or your state's page in the table above.
- What is the difference between a Medicaid renewal and a redetermination?
- A renewal is the regular check at the end of your coverage period. Redetermination is a broader word. It includes renewals and the checks a state does when you report a change between renewals.
- Will I lose Medicaid if my income goes up?
- Maybe. Report the change. The state will check whether you still qualify, including in other Medicaid groups. If you don't, you may be able to enroll in a Marketplace plan, and depending on your income, a premium tax credit can lower the monthly cost.
To apply for Medicaid or CHIP, use your state's official application or HealthCare.gov. Applying is free. FreedInsure can't enroll you in Medicaid or CHIP.
Sources
- CMS, SMD #26-001: Implementation of Eligibility Redeterminations, Section 71107 of Public Law 119-21 (March 6, 2026) (medicaid.gov), accessed October 19, 2026
- CMS, CMCS Informational Bulletin: Section 71119, Medicaid community engagement requirements (Dec. 8, 2025), including premium tax credit eligibility under section 1902(xx)(7)(B) (medicaid.gov), accessed October 19, 2026
- CMS, CMCS Informational Bulletin: Summary of Medicaid and CHIP provisions in Public Law 119-21 (Nov. 18, 2025), including Section 71102 (pause of the 2024 eligibility rule) and Section 71112 (retroactive coverage) (medicaid.gov), accessed October 19, 2026
- 42 CFR 435.916, Periodic renewal of Medicaid eligibility, as in effect June 2, 2024 (eCFR). CMS applies this version while Public Law 119-21 pauses the 2024 renewal amendments (ecfr.gov), accessed October 19, 2026
- 42 CFR 431.210, Content of notice (eCFR) (ecfr.gov), accessed October 19, 2026
- 42 CFR 431.211, Advance notice (eCFR) (ecfr.gov), accessed October 19, 2026
- 42 CFR 431.221, Request for hearing (eCFR) (ecfr.gov), accessed October 19, 2026
- 42 CFR 431.230, Maintaining services (eCFR) (ecfr.gov), accessed October 19, 2026
- HealthCare.gov, Special Enrollment Periods, accessed October 19, 2026
- HealthCare.gov, Medicaid & CHIP coverage (apply any time of year), accessed October 19, 2026
- Medicaid.gov, Unwinding and returning to regular operations after COVID-19, accessed October 19, 2026
- KFF, Medicaid Enrollment Tracker: archived unwinding data (as of Sept. 12, 2024) (kff.org), accessed October 19, 2026
- 42 CFR 51c.303, Other requirements for community health centers (sliding fee discounts; no denial for inability to pay) (law.cornell.edu), accessed October 19, 2026
- IRS, Financial assistance policies (FAPs) for tax-exempt hospitals (irs.gov), accessed October 19, 2026
- Each state's own Medicaid or benefits website (the page linked in each row), opened and checked for renewal information; to confirm your state's Medicaid agency, see Medicaid.gov's directory of state Medicaid and CHIP agencies, accessed October 19, 2026
Part of: Medicaid