Medicaid and the Marketplace

I learned that my Medicaid coverage has ended. What do I do now?

If you lose Medicaid but think you still qualify, contact your Medicaid agency. If your coverage ended less than 90 days ago, you may be able to submit any required forms and documents and have your coverage reinstated. In this case, your coverage will be retroactive back to your date of disenrollment. If your coverage ended more than 90 days ago, you will likely need to reapply for Medicaid.

If the Medicaid agency says you are no longer eligible for Medicaid but you believe that decision was made in error, you can file an appeal. The information on appeal and fair hearing rights as well as how to file an appeal should be included in the notice you received telling you that your Medicaid coverage was ending. If that information was not clear or was not included in the notice, contact your state Medicaid agency to ask about the steps needed to file an appeal.

If you are no longer eligible for Medicaid, you can apply for private health insurance through your employer if that is offered to you. Generally, to sign up for job-based coverage outside of the normal annual open enrollment, you must apply within 60 days of losing your Medicaid. Finally, you can sign up for private coverage through the Marketplace and will have more time available to do this. If you have any further questions regarding your Medicaid coverage, you can obtain assistance from a Navigator or other Enrollment Assister by going to HealthCare.gov and clicking on Find Local Help.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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