Medicaid provides essential healthcare coverage to millions of low-income individuals and families, but enrollment isn’t a one-and-done process. To stay covered, you need to prove you still qualify—and that’s where Medicaid redetermination comes in. With recent policy shifts following the end of the COVID-19 public health emergency, millions of Americans are facing redetermination for the first time in years. If you’re not sure what that means or how to stay enrolled, here’s what you need to know to keep your coverage and avoid gaps in care.
What Is Medicaid Redetermination?
Medicaid redetermination (also called Medicaid renewal or recertification) is the process where your state reviews your information to ensure you still meet eligibility requirements for the program. These reviews happen at least once a year and involve verifying your income, household size, residency, and other details.
If your situation has changed—or if you don’t complete the renewal process correctly—you could lose your Medicaid coverage.
Why Redetermination Matters Now
During the COVID-19 pandemic, states were required to keep people continuously enrolled in Medicaid as part of the federal public health emergency rules. That meant millions of people remained covered without needing to update their information, even if their circumstances changed.
That continuous coverage requirement ended in early 2023, which means states are now resuming regular eligibility checks. This shift has triggered the largest wave of Medicaid redeterminations in years, and millions of people risk losing coverage simply because of paperwork issues or outdated information.
What Triggers a Redetermination?
Redetermination can happen:
Annually (usually around your original enrollment date)
After a reported change in income, household size, or employment
When a child turns a certain age and eligibility must be rechecked
As part of a state’s regular review cycle, especially post-COVID changes
You’ll typically get a notice by mail, email, or text (depending on how your state Medicaid office communicates) when it’s time to renew.
What You’ll Need to Renew
To complete your Medicaid redetermination, you’ll likely be asked to provide:
Proof of income (recent pay stubs, tax returns, or benefits letters)
Identification documents (like a driver’s license or Social Security card)
Proof of address (utility bills or lease agreements)
Immigration status or citizenship documentation (if applicable)
Any recent changes to your household (marriage, birth of a child, job changes)
It’s important to respond quickly and completely. Ignoring the notice or missing the deadline could result in losing your benefits—even if you still qualify.
How to Stay Covered
Update Your Contact Information
If you’ve moved or changed your phone number or email address, make sure your state Medicaid office has your current details. Many people miss renewal notices simply because the mail went to an old address.Watch for Renewal Notices
Keep an eye out for letters or emails from your state’s Medicaid program. These will typically arrive in the month leading up to your redetermination deadline.Submit Paperwork Promptly
Respond to renewal requests as soon as possible—even if you think your information hasn’t changed. Some states offer online portals to make this easier and faster.Ask for Help if You Need It
Many states have hotlines, community health centers, or non-profits that assist with Medicaid applications and renewals. Don’t be afraid to reach out if the process feels confusing.Know Your Appeal Rights
If you’re denied coverage and believe it’s a mistake, you have the right to appeal. Act quickly—there’s usually a limited time to file an appeal or request a hearing.
What If You No Longer Qualify?
If you lose Medicaid coverage because your income or circumstances have changed, you may still have options:
Marketplace Insurance (ACA Plans): Losing Medicaid is a qualifying life event that opens a special enrollment period on the Health Insurance Marketplace.
Subsidies and Tax Credits: Depending on your income, you may qualify for low-cost or no-cost premiums on ACA plans.
CHIP (Children’s Health Insurance Program): If your child no longer qualifies for Medicaid but you earn too much for continued coverage, they may still be eligible for CHIP.
It’s important to act fast—you typically have 60 days after losing Medicaid to enroll in another plan without waiting for the next open enrollment period.
Common Mistakes to Avoid
Ignoring renewal notices
Assuming your coverage will continue automatically
Letting documents or deadlines slip
Failing to report income changes (which could result in overpayments or penalties)
Not checking your online account or email for updates
Final Thoughts
Medicaid redetermination is a normal part of staying covered—but after years of automatic renewals, many people are unprepared. The best way to keep your healthcare benefits is to stay informed, stay organized, and respond to your renewal request as soon as you receive it. Don’t let paperwork cost you your coverage. With a little preparation, you can continue accessing the care you need—without interruption.
