Medicaid Renewal: How Does It Work?

Medicaid renewal is also called Medicaid recertification and Medicaid redetermination. The program reviews a person’s medical needs and income to find out if they still qualify. 

Each state sets its own requirements for Medicaid and the Children’s Health Insurance Program, known as Children’s Medicaid or CHIP. If you are unsure whether you or your child still qualifies for Medicaid or CHIP, you will need to contact your state’s Medicaid agency. 

The Medicaid renewal rules changed during the COVID-19 public health emergency (PHE). Instead of yearly renewals, states were required to have continuous enrollment without renewal. This meant people who qualified for Medicaid and CHIP received ongoing coverage without reviews of their eligibility. 

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At the PHE’s conclusion, automatic renewal will end and millions of people are expected to lose coverage. This process is also called the “unwinding” for CHIP and Medicaid. 

If you have Medicaid, you’ll need to be prepared for the end of automatic renewal so that you don’t lose your insurance if you still qualify for coverage.

How does Medicaid renewal work? 

Medicaid is federally funded health insurance for people with low incomes. The program is run by all 50 states, the District of Columbia, and 5 U.S. territories:

• American Samoa

• Guam

• Northern Mariana Islands

• Puerto Rico

• U.S. Virgin Islands

Medicaid renewal normally happens annually. Once the PHE ends and Medicaid renewals restart, you’ll need to:

1. Make sure the Medicaid office in your state has your correct contact information. This is especially important if you have moved. But even if you haven’t moved, ensure that the information they have is correct. If you can, provide more than an address.

2. Look for a letter in the mail when it is time for your case to be reviewed. The letter may request information or ask you to take action.

3. Respond to the letter by confirming or submitting information as needed.

4. Wait for your state’s Medicaid agency to complete the review and make a decision.

Losing your Medicaid coverage will trigger a Special Enrollment Period (SEP) that gives you a chance to purchase a different insurance plan on an Affordable Care Act (ACA) marketplace.

If you lose your Medicaid or CHIP coverage because of the end of the PHE, you qualify for an unwinding special enrollment period. This period will last from March 31, 2023 to July 31, 2024. If you are eligible for marketplace coverage, you will be able to apply for and enroll in an ACA health plan at any time during the unwinding enrollment period.

Does Medicaid renew automatically? 

Not after the COVID PHE ends. As of March 31, 2023, states have a year to resume their yearly Medicaid eligibility review and renewal process. That means your Medicaid and CHIP coverage will no longer renew automatically.

Eligibility requirements vary by state and you will have to meet them annually going forward.

Do you have to renew Medicaid every year?

Yes. States require Medicaid and CHIP eligibility to be reviewed annually. You will receive a letter in the mail with renewal instructions. Make sure your state Medicaid office has your current address and other contact information.

What happens if you miss the Medicaid renewal deadline? 

Each year, your state’s Medicaid office will mail you essential renewal information. If you miss the deadline to submit your paperwork, your Medicaid or CHIP will not be renewed. You should reapply if you lose your Medicaid coverage but believe you are still eligible.

Will the Medicaid renewal process change at the end of the COVID-19 public health emergency?  

Yes. As discussed, continuous coverage — which paused eligibility reviews and automatically renewed Medicaid and CHIP — will end. States will have 12 months to start renewals and 14 months to complete renewals for everyone enrolled in Medicaid and CHIP.

That year of adjustment is part of the “unwinding” that was mentioned earlier.

Researchers have estimated that as many as 15 million people may lose Medicaid and CHIP coverage during the unwinding period. Many of those people will lose their insurance despite being eligible.

Certain eligible people are expected to have a greater risk of losing Medicaid and CHIP coverage:

• People who have moved during the pandemic

• People with limited English proficiency

• People with disabilities

States are required to have plans to prevent eligible people from losing coverage during the unwinding — including more than one way to communicate with enrollees and outreach through partner organizations. 

If you are worried you or your child might lose Medicaid or CHIP during the unwinding period, make sure your state’s Medicaid agency has another way to contact you beyond your address, if possible. You may encounter long waits to speak to someone on the phone or in person.

How can you lose your Medicaid eligibility?

During your renewal, you could lose eligibility if:

• Your income increases above your state’s annual income requirements

• Your health status changes

• You move to a different state or territory

• You don’t pay monthly premiums, which are very low in the states that charge them

• You lose your Supplemental Security Income (SSI) — but not always because it’s a separate review process

• You enter or leave a long-term care facility, treatment center, prison, or other institution

• You commit fraud by actions such as sharing your Medicaid card or filing false claims

You can also lose coverage if your state Medicaid agency can’t reach you to confirm your eligibility.

How do you check your Medicaid status? 

You can check your Medicaid status by contacting your state’s Medicaid agency. Medicaid information by state is provided below.

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Written by:

Lisa Kaelin

Lisa Kaelin is an author, editor, and artist. She has nearly 2 decades of experience writing and editing online personal finance content.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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