Staying covered if you lose Medicaid or CHIP

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For the past few years, states had to continue your coverage in Medicaid (and in some cases the Children’s Health Insurance Program (CHIP)), even if your income or other factors changed that would typically make you ineligible.

States are now returning to normal operations, so your state will start checking eligibility for these programs again. Your state will reach out to you if they need more information to check if you're still eligible to keep your coverage. You can prepare by updating your contact information with your state and checking your mail for a letter from your state. Complete and submit any forms your state asks for right away.

If your state finds that your household income is too high or other changes make you ineligible, you may lose your Medicaid or CHIP coverage.

The Marketplace may contact you. When you lose Medicaid or CHIP coverage, your state securely sends your contact information to the Marketplace. We’ll use it to mail you a letter about Marketplace coverage. We may also follow up with you by phone, text, or email, if you gave that contact information to your state. You don’t need to wait for us to contact you to apply for coverage.

Apply for Marketplace coverage right away

• You may be able to get low-cost, quality health coverage through the
  

A service that helps people shop for and enroll in health insurance. The federal government operates the Health Insurance Marketplace®, available at HealthCare.gov, for most states. Some states run their own Marketplaces. Refer to glossary for more details.

You can apply and enroll in a Marketplace plan as early as 60 days before your Medicaid or CHIP coverage ends to avoid a gap in coverage. Between March 31, 2023 and November 30, 2024, you can also apply for a Marketplace plan anytime after your Medicaid or CHIP coverage ends and you will have 60 days after submitting your application to enroll in a plan that will start at the beginning of the next month after you complete your enrollment.

Most people qualify for savings

• Savings, like a

A tax credit you can take in advance to lower your monthly health insurance payment (or “premium”). When you apply for coverage in the Health Insurance Marketplace®, you estimate your expected income for the year. If you qualify for a premium tax credit based on your estimate, you can use any amount of the credit in advance to lower your premium. Refer to glossary for more details.

A discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance. In the Health Insurance Marketplace®, cost-sharing reductions are often called “extra savings.” If you qualify, you must enroll in a plan in the Silver category to get the extra savings. Refer to glossary for more details.

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself. Refer to glossary for more details.

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible. Refer to glossary for more details.

Local help in your community

About a month after we send you the first letter, if you haven’t enrolled in coverage, we may send you another letter with information about an assister organization that works with us to help your local community. Marketplace assisters provide free, fair, impartial, and accurate information to you and your household.

A Marketplace assister in your community may contact you by phone, text, or email with the information you provided to your state Medicaid or CHIP agency. Assisters are trained by us to give you information about your health coverage options, answer your questions, and help you enroll in a Marketplace plan, Medicaid, or CHIP. Assisters will:

• Never ask you for your credit card number or any other form of payment
  • Their services to help you get health coverage are free of charge
  • When you enroll in a health plan, you’ll always pay your premiums directly to the insurance company – never to the Marketplace or its assisters.

  What do I do if someone contacts me and says they’re a Marketplace assister?

  Confirm who they are before providing any information. Ask for their name, who they work for, and their organization’s phone number, street address, mailing address, email address, and website. Write this information down. Compare it to the organization listed in the letter you got from the Marketplace.

  You can also call the Marketplace Call Center any time for help with Marketplace coverage.

  To get help with your coverage options or to apply for Marketplace coverage, find local help near you or contact the Marketplace Call Center.

  Say no to scams
  Don’t share your personal information or give money to anyone saying you have to pay them to keep Medicaid or CHIP coverage or apply for Marketplace coverage. The Marketplace, assister organizations, and your state will never threaten you or anyone in your household or ask for your credit card information or payment to keep or qualify for health coverage.

  Report it if someone calls, emails, or texts you asking for:
  • Your personal information (like your Social Security Number)
  • Money (like credit card payment, gift cards, cash, prepaid debit card, or cryptocurrency)
  • Or, if they threaten you or anyone in your household with legal action

  Re-apply if you lost or will soon lose Medicaid or CHIP

  If your state says you’re no longer eligible for Medicaid or CHIP coverage, you can re-apply through your state to find out if you still qualify. (In all states, Medicaid and CHIP offers health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities.)

  Check with your employer about job-based coverage

  Learn more about the Marketplace:

  • Get details and steps for applying after losing Medicaid/CHIP
  • Check if you qualify for savings before you apply
  • Preview plans and prices
  • Find local help
  • Browse full list of items Marketplace plans cover
    

  Qualify for Medicare?
  If you now qualify for Medicare but didn't sign up for it when you first became eligible, you may be able to sign up for Medicare without paying a late enrollment penalty.