Are you losing Medicaid eligibility? Here’s what to do next.

Can I reapply for Medicaid after my coverage is terminated?

Yes. Enrollment is open year-round, which means you can reapply for Medicaid anytime. So if your circumstances change and you think you once again meet the eligibility criteria (perhaps you experienced a pay cut or job loss), file a new application.

If you lost Medicaid eligibility because you didn’t complete the renewal process, you have a 90-day window when you can get your coverage reinstated if you complete the renewal and are determined eligible.²

What are my coverage options if I’m losing Medicaid?

If you’re losing Medicaid and are eligible for coverage from your employer or your spouse’s employer, you’ll be able to enroll in that health plan. You also have the option to enroll in a plan offered through the Marketplace/exchange in your state. Here’s what you need to know about these coverage options:

• If you have access to an employer’s plan that’s considered comprehensive and affordable, that’s likely to be your best option. (Access to an employer’s plan will vary from one employer to another. Some offer coverage only to full-time workers, while others also offer coverage to part-time employees.) Take the necessary steps to enroll in that plan as soon as you receive notice that your Medicaid is ending. The special enrollment period will continue for 60 days after your Medicaid ends,³ but it’s best to sign up before the date your Medicaid ends, so that you avoid a gap in coverage. (Note: Special enrollment periods typically only last for 30 days for employer-sponsored coverage, but the window is longer if the qualifying life event is loss of Medicaid.)⁴
• If you do not have access to a comprehensive, affordable plan from an employer, you can enroll in a plan through the Marketplace/exchange. Most Marketplace enrollees qualify for income-based subsidies to offset the cost.⁵ (To be clear, Marketplace coverage is an option for nearly anyone, but financial subsidies are only available if you don’t have access to an affordable, comprehensive plan offered by an employer.) Your special enrollment period due to loss of coverage will continue for 60 days after your Medicaid ends, but you’ll need to enroll before your Medicaid ends in order to avoid a gap in coverage.
• Note: If you lose Medicaid because you’re not complying with the work requirement (for Medicaid expansion enrollees), you will not be eligible for a Marketplace subsidy unless your income increases to a subsidy-eligible level. If your income remains in the Medicaid-eligible range, the Marketplace will still consider you to be Medicaid-eligible (and thus not subsidy-eligible) if the only reason you don’t qualify for Medicaid is that you’re not in compliance with the work requirement.⁶
• If you are eligible for Medicare and haven’t enrolled because you had Medicaid, you’ll have a six-month window when you can transition to Medicare without a late-enrollment penalty. Here’s more about transitioning from expanded Medicaid to Medicare. If you’re under 65 and have become eligible for Medicare due to a long-term disability, there’s state-to-state variation in terms of Medigap access.

What if I can’t afford health insurance and don’t qualify for Medicaid?

Most Marketplace enrollees qualify for premium subsidies, and the federal government fixed the “family glitch” in 2023, making some employees’ family members newly eligible for Marketplace subsidies.

So most people who aren’t eligible for Medicaid, Medicare, or an employer’s health plan can enroll in affordable Marketplace coverage. But there are some circumstances when subsidies aren’t available regardless of affordability, including:

• very low-income adults in states that haven’t expanded Medicaid,
• people who earn more than 400% of the federal poverty level,
• people who are ineligible to use the Marketplace because they’re not lawfully present in the U.S.
• some lawfully present immigrants who are no longer eligible for Marketplace subsidies as of 2027.

Learn more: I can’t afford health insurance and I’m not eligible for Medicaid.

There are various medical providers throughout the U.S. that can be used by people who don’t have health insurance, including federally qualified health centers, safety net hospitals, and free or sliding-scale clinics.

If I’m losing Medicaid eligibility, what happens to my child’s coverage?

Even if you’re no longer eligible for Medicaid, your child still may be eligible for Medicaid or the Children’s Health Insurance Program (CHIP). In every state, children can access these programs with higher household income levels than adults.⁷ So your ineligibility does not necessarily translate to your entire household.

If your kids are not eligible for Medicaid or CHIP, you may be able to secure coverage for them through an employer or the Marketplace under the same terms discussed above.