I recently lost my Medicaid health coverage. What should I do now?

Joanna Doran, cancer rights attorney and CEO at Triage Cancer in Chicago

During the COVID-19 pandemic, the federal government gave states permission to stop reviewing Medicaid eligibility so more people could maintain access to medical care. Medicaid continuous enrollment, as this period is known, ended on March 31, 2023. As of April 1, 2023, states could begin to verify eligibility for Medicaid again and disenroll people who no longer qualify. Already millions of people have lost Medicaid coverage because of this “unwinding” process.

While it’s normal for states to require recertification to ensure those receiving Medicaid are still eligible for the program, they’re now sending mailings to all Medicaid beneficiaries at once and imposing short deadlines. Each state has a different timeline and process, but many states have already asked individuals to submit proof that they still qualify. Unfortunately, providing this proof can be complicated logistically.

As of December 2023 in states for which data are available, 71% of people who’ve had their Medicaid terminated lost coverage as a result of not submitting paperwork. Those who have lost coverage have a limited time to submit paperwork and to get coverage reinstated if they still qualify. Some of the details will vary depending on the rules in each state. Call your state Medicaid office for more information.

If you turned in your paperwork and were disenrolled but you think you should still qualify for Medicaid, you can appeal the decision by providing additional information. Your state Medicaid office is a place to go for questions. Look for a case worker or community-based organizations that may offer additional advice or assistance. When you appeal a denial of Medicaid coverage, it goes through a fair hearing process. You can get help with this from a local legal aid office.

If you are no longer eligible for Medicaid—perhaps you are working more now and your income level is too high to qualify—then it’s time to consider other options. Is there coverage available through your job or your spouse’s job? If you are under 26, could you go back on your parent’s plan? Also consider your state’s health insurance marketplace. If you’ve just lost Medicaid, you’ll have a 90-day special enrollment period during which to pick a plan through the marketplace. Depending on the size of your household and your income, you may be eligible for financial assistance. Most people enrolling through the marketplace can get plans for $10 or less per month after tax credits.

If you are still facing a gap in your health care coverage and are currently receiving treatment, ask if your hospital offers charity care, which is financial assistance for low-income patients. Nonprofit hospitals should proactively share information about financial assistance programs, but it’s always a good idea to ask what programs they offer. The key is to know your options and get the coverage you need as soon as possible.

GET COVERED // Dollar For, a nonprofit that helps patients access charity care, will help you learn if you qualify for financial assistance at your hospital. // HealthCare.gov offers tips about using the health insurance marketplace, including information about how to know if you qualify for savings.

The expert’s response was edited for clarity and based on an interview with Kendall K. Morgan.