How Do You Renew Medicaid, and What If You Lose Coverage? (2027)

Quick answer: how Medicaid renewal works in 2027

It depends on your group. Most people renew Medicaid once every 12 months, but adults in the expansion group renew every 6 months for renewals scheduled on or after January 1, 2027. To keep coverage, return your renewal form within the deadline (at least 30 days). If coverage ends, you can request a fair hearing and enroll through HealthCare.gov, which allows 90 days after losing Medicaid.

Medicaid renewal frequency in 2027: who renews every 6 months

Adults in the Medicaid expansion group, meaning adults 19 to 64 with income up to 138% of the Federal Poverty Level ($22,025 for one person in 2026), must renew every 6 months for renewals scheduled on or after January 1, 2027. CMS lets states either reset renewal dates for everyone enrolled on that day or move people to the 6-month cycle at their next scheduled renewal, so the date of your first 6-month renewal depends on your state's choice and is printed on your notice.

Everyone else keeps the federal once-every-12-months rule in 42 CFR 435.916: children, parents and caretakers in other groups, pregnant people, and people covered because of age or disability. American Indians and Alaska Natives in the expansion group are exempt from the 6-month rule. Whether Section 1115 waiver adults are included depends on the waiver, so read your state notice rather than assuming either way.

Work requirements add a second check at the same moment. Expansion adults in states that apply the 2025 federal work rule must show 80 hours a month of work, school, job training or volunteering, or monthly income of at least 80 times the federal minimum wage ($580 a month in 2026), and states verify this at renewal. Nebraska has run the rule since May 1, 2026, Montana since July 1, 2026, and every other expansion state must start by January 1, 2027 unless it receives a good-faith exemption. Parents or caretakers of a child 13 or younger, pregnant people and people who are medically frail are exempt.

What to do when your Medicaid renewal notice arrives

Your state begins every renewal with an ex parte check, meaning it searches wage, tax and other databases and renews you without asking for anything if the data show you still qualify (42 CFR 435.916(a)(2)). If the data cannot confirm eligibility, the state sends a prepopulated renewal form and must give you at least 30 days to return it with any requested documents. A renewal form is not junk mail: ignoring it is the most common way people lose Medicaid while still eligible.

Medicaid renewal in 2027 works best as a routine. Confirm your mailing address, phone and email with your state agency today, because notices go to the contact information on file. Check your online account each time you receive any state letter, and set a calendar reminder 5 months after each renewal if you are in the 6-month group.

• Update your address, phone and email with your state Medicaid agency before any notice is due.
• Open every letter from the state and check the response deadline, which is at least 30 days from the form date.
• Correct anything wrong on the prepopulated form: household members, income, address.
• Attach the documents the notice asks for, such as recent pay stubs, and keep copies.
• Submit by the channel your state offers (online account, phone, mail or in person) and save the confirmation number.
• If a work requirement applies to you, include proof of hours, school enrollment or an exemption.

Missed your Medicaid renewal deadline? The 90-day reconsideration window

A missed deadline does not have to end coverage for good. When a state terminates Medicaid because you did not return the renewal form or documents, federal rules in 42 CFR 435.916(a)(3)(iii) require the state to reconsider your eligibility without a new application if you submit the missing information within 90 days after the termination date, or a longer period if your state elects one. Send the form the day you notice the problem and ask the agency to confirm in writing that it was received.

Other terminations work differently. If the state decides your income is over the limit, or that you did not meet a work requirement, the 90-day paperwork window may not apply and you generally need a fair hearing request, a new application, or both. Medicaid has no enrollment window, so you can reapply any day of the year, but your state may apply the work requirement again at that new application.

The week you lose Medicaid: a day-by-day plan for 2027

A Medicaid termination notice arrives with a stated reason and an end date, and federal rules generally require at least 10 days of advance notice before coverage stops (42 CFR 431.211). Those days are the most valuable of the whole process because they let you fix paperwork, appeal with benefits continuing, and line up a new plan so there is no gap. Treat the notice as a deadline, not a verdict.

• Day 1: Read the reason and the end date. Save the envelope or a screenshot of the portal message.
• Days 1 to 2: If the reason is missing paperwork, return it now and ask for the 90-day reconsideration in writing.
• Days 1 to 3: If you think the decision is wrong, request a fair hearing before the end date. Asking within the notice period generally keeps benefits going while the appeal is decided (42 CFR 431.230), and most states allow up to 90 days to request a hearing.
• Days 3 to 5: Go to HealthCare.gov or your state Marketplace, report the loss of Medicaid, and compare plans.
• Days 5 to 7: Select a plan, upload the termination letter if asked, and pay the first premium so coverage activates.
• Afterward: Tell your doctors and pharmacy about the change and keep every notice for 12 months.

Moving to a Marketplace plan after Medicaid: the 2027 special enrollment period

HealthCare.gov says you may qualify for a special enrollment period if you lost Medicaid or CHIP coverage in the past 90 days, and the general loss-of-coverage rule allows 60 days before or 60 days after the loss. State-based Marketplaces can set their own windows, so confirm yours. Pick the plan before Medicaid ends when you can, because enrolling early is the best way to avoid an uninsured month, and keep the termination notice as proof.

Savings depend on the coverage year. For 2027 coverage, sold from November 1, 2026 with open enrollment running to January 15, 2027, premium tax credits apply from $15,960 to $63,840 for one person and $33,000 to $132,000 for a family of 4, with expected contributions of 2.15% to 10.22% of income. For 2026 coverage, which applies if your Medicaid ends in November or December 2026, the range is $15,650 to $62,600 for one person and $32,150 to $128,600 for 4, with contributions of 2.10% to 9.96% of income. Every ACA-compliant plan covers the essential health benefits and cannot turn you away for a preexisting condition.

Two 2027 cautions apply. First, starting in 2027 in states required to run a work requirement, adults who lose or are denied Medicaid solely for not meeting it are ineligible for Marketplace premium tax credits (KFF), though they can still buy a full-price plan; the bar lasts until Medicaid is lost for another reason, such as an income change. Second, from tax year 2026 there is no cap on repaying excess advance premium tax credits at any income, so update your Marketplace income estimate whenever it changes.

Alternatives if you lose Medicaid and cannot get it back right away

Several routes keep you covered while a Medicaid decision is pending or if you no longer qualify in 2027. Each of the options below is a real program with a public starting point, and more than one can apply at the same time.

• Reapply for Medicaid: applications are accepted year-round at healthcare.gov/medicaid-chip, and a drop in income or a new exemption can change the result.
• Marketplace plan with a premium tax credit: use the special enrollment period at HealthCare.gov, as described above.
• Employer plan: losing Medicaid or CHIP generally opens a 60-day special enrollment right in a job-based plan under federal law, so ask your employer's benefits office right away.
• Community health center: federally funded centers charge on a sliding scale by income; search at findahealthcenter.hrsa.gov.
• CHIP for children: a child can stay covered through CHIP or Medicaid even when a parent loses coverage, because income limits for kids are higher.
• Turning 65: Original Medicare (Part A and Part B), Medicare Advantage, Medigap and Part D are a separate enrollment path at medicare.gov.

How often do you have to renew Medicaid?

Most people renew once every 12 months under 42 CFR 435.916. Adults in the Medicaid expansion group renew every 6 months for renewals scheduled on or after January 1, 2027, according to CMS guidance SMD #26-001 (March 2026). American Indians and Alaska Natives are exempt from the 6-month rule. Your state notice shows your exact date.

What happens if I miss my Medicaid renewal?

Your state may end coverage for failing to respond, but federal rules let you submit the missing renewal information within 90 days after termination, or longer if your state allows, and have eligibility reconsidered without a new application. After that window you generally must file a new application. Act the day you notice the problem.

What is Medicaid redetermination?

Redetermination is the formal name for Medicaid renewal: the state's review of whether you still meet income, residency, immigration and other rules. It is not the same as the 2023 to 2024 unwinding after the pandemic continuous coverage rule ended. In 2027 the term mainly describes the regular annual or 6-month check.

Do I still need to do anything if my state renews me automatically?

Not always. Under the ex parte process, the state first tries to renew you using data it already holds and sends no form if that works. If it needs more, you receive a prepopulated form with at least 30 days to answer. Keep your contact information current so you do not miss it.

How long do I have to get a Marketplace plan after losing Medicaid?

HealthCare.gov says you may qualify for a special enrollment period if you lost Medicaid or CHIP in the past 90 days, and the general rule allows 60 days before or after losing coverage. State-based Marketplaces set their own windows, so check yours and keep the termination notice.

Will the 2027 work requirement affect my renewal?

If you are an expansion adult in a state that applies it, yes. States check work, school, training or volunteering hours at renewal, with exemptions for parents of children 13 or younger, pregnant people and medically frail adults. Starting in 2027, losing Medicaid solely for not meeting it also bars Marketplace premium tax credits in those states, per KFF.

Can I appeal if Medicaid ends?

Yes. You can request a fair hearing, and most states allow up to 90 days from the notice. If you ask before the termination date, benefits generally continue during the appeal under 42 CFR 431.230. Write down the date you asked and keep a copy of the request.

What if my income went up and I no longer qualify?

Move to a Marketplace plan, where premium tax credits cover income from $15,960 to $63,840 for one person for 2027 coverage. Report income changes during the year, because from tax year 2026 excess advance credits must be repaid in full at any income.