Michigan Medicaid coverage ends for a few common reasons in 2026: a renewal packet was not returned through MI Bridges, MDHHS data matching shows household income above the 2026 limit, or a change such as a move, a new job, or turning 65 changed eligibility. Whatever the reason, the termination notice is a qualifying life event for the Marketplace. Federal rules published at HealthCare.gov give anyone who loses Medicaid or CHIP a 90-day Special Enrollment Period to enroll in a Marketplace plan with premium tax credits. Michigan runs on the federal HealthCare.gov platform rather than a state-run exchange, so that 90-day rule applies directly to Michigan residents. The window runs from the date your coverage ends, not the date you open the letter, so reading the effective date on your notice is the first task. Many Michiganders can also challenge the termination. A hearing request filed within 90 days of the notice date can reverse a procedural termination, and a request filed before the effective date on the notice may keep benefits running during the appeal. Pursue both tracks at once: enroll in a Marketplace plan as a safety net and request the hearing as the path back to free coverage. A Marketplace plan can be cancelled if Medicaid is reinstated, so the dual approach costs little and protects you from a gap.
Income decides which path fits in Michigan. The Healthy Michigan Plan covers adults ages 19 to 64 at or below 138% of the federal poverty level, which is $22,025 per year for one person and $45,540 for a family of four in 2026. Adults above that line, up to 400% FPL ($63,840 for one person in 2026), qualify for premium tax credits on HealthCare.gov plans, and adults at or below 250% FPL in 2026 can get cost-sharing reductions on Silver plans. Enhanced premium tax credits expired January 1, 2026, so the 400% FPL subsidy cliff is back this year. Children have separate coverage: Healthy Kids Medicaid and MIChild work year-round with no enrollment deadline, and a parent losing coverage does not automatically end a child's coverage. Federal H.R. 1 also reshapes Michigan Medicaid from January 1, 2027, with work and community engagement rules for Healthy Michigan Plan adults, six-month renewals, and a shorter look-back for retroactive coverage. MDHHS has published guidance, but details such as required hours should be confirmed on michigan.gov before you rely on them. The sections below lay out the steps, deadlines, costs, and documents for the 2026 to 2027 transition.
7 Steps to Get Coverage
Common Mistakes That Cost People Thousands
Michigan residents who lose Medicaid in 2026 most often lose coverage a second time through avoidable errors with deadlines and income reporting.
- Waiting for the hearing result before enrolling in a Marketplace plan, which can burn the 90-day SEP window while the appeal is pending.
- Counting the 90 days from the day the letter arrives instead of the coverage end date printed on the MDHHS notice.
- Reporting 2025 income to HealthCare.gov instead of projected 2026 income, which can cause a wrong premium tax credit and a bill at tax time.
- Assuming you no longer qualify because of one high-income month, when Healthy Michigan Plan eligibility uses current monthly income and may still apply.
- Forgetting the children, who can stay covered through Healthy Kids or MIChild year-round even when a parent is uninsured.
- Ignoring the Form 1095-A that arrives in early 2027, which is required to reconcile 2026 premium tax credits.
Why Michigan Medicaid Coverage Ends in 2026 and What Triggers the Marketplace SEP
Michigan Medicaid terminations in 2026 fall into three groups, and each group points to a different next step. First, income-based terminations happen when MDHHS data matching shows household income above 138% FPL for adults ($22,025 for one person in 2026), and those adults usually move to a Marketplace plan with a premium tax credit. Second, procedural terminations happen when a renewal form or verification is not returned through MI Bridges or by mail, even though the member may still qualify. Procedural terminations are the strongest candidates for a hearing request or a fast reapplication. Third, life changes such as moving out of Michigan, gaining job-based coverage, or turning 65 end Medicaid for reasons that do not call for an appeal. In each case the termination notice is the document that proves your qualifying life event, so keep it with your records and note the effective date. Keep a dated copy of every renewal form you send, since MDHHS can only reverse a procedural termination when the file shows what you returned and when.
Federal Special Enrollment Period rules treat losing Medicaid or CHIP as a qualifying life event. HealthCare.gov states that people who lost Medicaid or CHIP coverage in the past 90 days can enroll in a Marketplace plan outside Open Enrollment, which is longer than the 60-day window for most other coverage losses. Michigan has no state-run exchange, so the federal rule applies as written. HealthCare.gov also describes an option to apply before a loss when you expect it, but whether that advance window applies to Medicaid depends on the notice you received, so confirm it on HealthCare.gov or with the Marketplace Call Center at 1-800-318-2596. Plan to apply early in the 90 days, because HealthCare.gov may request documents to verify the loss and a delay in verification can push back your coverage start date. Verification also matters: upload the notice as soon as HealthCare.gov asks, and keep the confirmation page, because an unresolved data matching issue can delay plan activation even when the 90-day window is still open.
Healthy Michigan Plan Income Limits and ACA Subsidy Thresholds in Michigan 2026
Michigan income limits for 2026 create a ladder with three steps. Adults ages 19 to 64 at or below 138% FPL ($22,025 for one person, $45,540 for a family of four in 2026) qualify for the Healthy Michigan Plan, which Michigan launched under its 2014 Medicaid expansion. Between 138% and 400% FPL ($63,840 for one person, $132,000 for a family of four in 2026), adults qualify for premium tax credits on HealthCare.gov plans, with larger credits at lower incomes. Above 400% FPL in 2026, Michigan adults pay full Marketplace premiums because the subsidy cliff returned when enhanced premium tax credits from ARPA and the IRA expired January 1, 2026. Check the household-size table on this page against your family size, and use projected 2026 income and not last year's tax return. Families should also count everyone in the tax household, since MAGI household size determines the threshold. A family of four at $45,540 in 2026 is at the Healthy Michigan Plan line, while a single adult at that income is well above it.
Cost-sharing reductions make the Medicaid-to-Marketplace move most affordable between 138% and 250% FPL in 2026. Silver plans bought through HealthCare.gov in that range carry lower deductibles, lower copays, and lower out-of-pocket maximums than the standard plan, while the 2026 federal out-of-pocket maximum for any Marketplace plan is $10,600 for an individual and $21,200 for a family. Cost-sharing reductions only attach to Silver plans, so a Bronze plan with a lower premium can cost more when you use care. Before assuming you lost Michigan Medicaid for good, check whether your monthly income still falls under 138% FPL in 2026, since a seasonal or temporary income spike can end coverage that you would regain by reporting current income through MI Bridges. Michigan residents can also compare Silver and Bronze net costs by entering expected 2026 medical use in the HealthCare.gov plan comparison tool, which shows an estimated total yearly cost that combines premiums with likely out-of-pocket spending.
Michigan Medicaid Changes Starting January 1, 2027: Work Requirements and Six-Month Renewals
Michigan Healthy Michigan Plan rules change on January 1, 2027 under federal H.R. 1, signed in 2025. KFF reports that states must begin Medicaid work requirements for expansion adults by January 1, 2027, and MDHHS has said Healthy Michigan Plan members ages 19 to 64 will be affected, with most moving from annual to six-month renewals. Partner guides describe ways to comply in 2027 such as 80 hours per month of work, job training, or volunteering, at least six credit hours of school per semester, or average earnings of at least $580 per month. Exemptions reported by MDHHS and partner guides include pregnant and postpartum women, American Indians and Alaska Natives, people with disabling conditions, certain caregivers, and people in substance use treatment. Treat those figures as unverified until you confirm them on michigan.gov, because federal rules and MDHHS guidance were still being finalized in 2026. Michigan members should also keep MI Bridges contact details current, because renewal notices and work-reporting requests will arrive there and by mail.
Planning for 2027 affects what you do now. Federal law as enacted in H.R. 1 also shortens retroactive Medicaid coverage for expansion adults, so a late application in 2027 may cover fewer past months than in 2026, and it restricts premium tax credits for people denied or disenrolled from Medicaid for not meeting work requirements. Reapply promptly if you lose Michigan Medicaid and qualify, keep proof of work hours or an exemption once the rules start, and respond to every six-month renewal notice from MDHHS. Separately, MDHHS and partner guides note that federal changes starting October 1, 2026 narrow Medicaid eligibility for some lawfully present immigrants, so households affected should check HealthCare.gov and MDHHS for current options. Verify each of these changes at michigan.gov, medicaid.gov, and kff.org before you act. Households should also watch for MDHHS mail and MI Bridges messages through late 2026, since early outreach about the new rules is expected before the January 1, 2027 start.
Frequently Asked Questions
What is the SEP window after losing Michigan Medicaid in 2026?
Your Marketplace Special Enrollment Period lasts 90 days from the date your Michigan Medicaid or CHIP coverage ends, according to HealthCare.gov. For example, if coverage ends October 31, 2026, you can enroll from November 1, 2026 through January 29, 2027. Michigan uses the federal HealthCare.gov platform, so this rule applies as written. Choose a plan before the final day and pay the first premium to activate coverage. Medicaid itself has no deadline for new applications, so you can reapply for the Healthy Michigan Plan at any time if your 2026 income is at or below 138% FPL.
What documents do I need to prove my Michigan Medicaid loss?
Your MDHHS termination notice is the primary proof of the qualifying life event, and it should show the coverage end date. HealthCare.gov may ask you to upload it if it cannot confirm the loss automatically. Gather Social Security numbers, proof of Michigan residence, and records of your projected 2026 income such as pay stubs or an unemployment award letter. Bring birth certificates for children and immigration documents for any non-citizen applicants. If you cannot find the notice, log in to MI Bridges at newmibridges.michigan.gov to view your case history or call the MDHHS Beneficiary Help Line at 800-642-3195 for a copy.
What happens if I miss the 90-day SEP window after losing Michigan Medicaid?
Missing the 90-day window generally means waiting for the next ACA Open Enrollment, which for 2027 coverage opens November 1, 2026, with HealthCare.gov listing January 15, 2027 as the closing date. Coverage from a late selection may not begin until January or February 2027, leaving a gap with no insurance. Medicaid is the exception: you can apply for the Healthy Michigan Plan, Healthy Kids, or MIChild year-round if you qualify. Another SEP, such as a move or a new job, may also open a window. Apply as early as you can in the 90 days to avoid relying on those backups.
Can I get retroactive coverage after losing Michigan Medicaid?
Retroactive coverage depends on the path you take. A successful Medicaid hearing generally reinstates coverage back to the termination date, so claims during the gap can be paid. A new Michigan Medicaid application can cover up to three months before the application month in 2026 if you were eligible then, though federal H.R. 1 shortens that look-back starting January 1, 2027. Marketplace coverage usually starts on the first day of the month after you pick a plan, so earlier months are not covered. Confirm start dates on HealthCare.gov when you enroll, and ask MDHHS about retroactive Medicaid when you reapply.
What is the difference between COBRA and the Marketplace after losing Michigan Medicaid?
COBRA applies only if you also lost employer coverage, since Medicaid has no COBRA option. COBRA costs 102% of the full premium, often $400 to $2,000/mo in 2026, with a 60-day election window from the qualifying event. Marketplace plans on HealthCare.gov use the 90-day Medicaid-loss SEP and can drop to $0 to $200/mo after 2026 premium tax credits for many incomes. COBRA makes sense mainly to keep a specific specialist or a met deductible. Anyone who lost both a job and Medicaid should compare both, and remember that COBRA cannot be combined with premium tax credits.
What Michigan-specific rules apply after losing Medicaid in 2026?
Michigan Marketplace enrollment runs through HealthCare.gov, while Medicaid, the Healthy Michigan Plan, Healthy Kids, and MIChild run through MDHHS and MI Bridges. A Medicaid hearing request is due within 90 calendar days of the notice date, and asking for continued benefits requires filing before the effective date on your notice. Federal H.R. 1 brings work and community engagement reporting and six-month renewals for Healthy Michigan Plan adults starting January 1, 2027. Some changes for lawfully present immigrants start October 1, 2026. Confirm each rule on michigan.gov, since MDHHS guidance was still evolving in 2026.
Do I still qualify for Medicaid in Michigan after a termination?
Michigan Medicaid through the Healthy Michigan Plan covers adults ages 19 to 64 with household income at or below 138% FPL, which is $22,025 for one person and $45,540 for a family of four in 2026. Your eligibility is based on current monthly income, so a termination caused by a missed renewal or a temporary income spike may be reversed or fixed by reapplying. If your 2026 income is above the line, the Marketplace pays through premium tax credits up to 400% FPL ($63,840 for one person in 2026). Compare your family size against the household-size table on this page or run the free screener.
What happens to my children's coverage if I lose Michigan Medicaid?
Children's coverage is separate from adult coverage in Michigan. Healthy Kids Medicaid and MIChild, the state's CHIP, are available year-round with no enrollment deadline, and your own termination does not automatically end a child's coverage. Reported MIChild income limits range from roughly 212% to 217% FPL in 2026 depending on the source, though MDHHS updates its tables each April, so confirm on michigan.gov. Check your children's status in MI Bridges, and apply for them even if your own Marketplace enrollment is still pending. If your children are uninsured, their coverage may be the quickest win after a family termination.
