Medicaid Renewal & Redetermination
Medicaid coverage is not permanent — it must be renewed periodically. Missing a renewal notice is the most common reason people lose coverage. Here's what to do before your renewal date.
Why Medicaid renewal exists
Federal law requires states to periodically redetermine whether Medicaid enrollees continue to meet eligibility requirements. This process — variously called renewal, redetermination, or recertification — exists to ensure that public funds go only to those who currently qualify. For most enrollees, redetermination happens on an annual basis, though some states use shorter or longer intervals for certain populations.
States are required to attempt to renew coverage through "ex parte" renewal whenever possible — meaning they try to verify your continued eligibility using data they already have from other government sources (such as tax records, SNAP enrollment, or Social Security data) without requiring you to submit paperwork. When ex parte renewal is not possible, the state sends you a renewal form that you must complete and return.
The Medicaid unwinding (post-pandemic)
During the COVID-19 public health emergency (March 2020 through March 2023), a federal continuous coverage requirement prevented states from terminating anyone's Medicaid coverage. As a result, Medicaid enrollment grew substantially during this period, reaching record levels. When Congress ended the continuous coverage protection in March 2023, all Medicaid enrollees — over 90 million people at the time — had to be redetermined over an extended period known as the "unwinding."
The unwinding had significant consequences. Millions of people lost Medicaid coverage during this period, and a substantial share of them lost coverage for procedural reasons rather than actual ineligibility — meaning they were likely still eligible but lost coverage because renewal paperwork was not returned or because contact information had changed. The unwinding highlighted the critical importance of keeping your address current with your state Medicaid agency and responding promptly to all renewal notices.
How renewal works
Here is what typically happens during the annual renewal process:
- Your state Medicaid agency sends a renewal notice 60 to 90 days before your coverage renewal date. This may arrive by mail, email, or text message depending on your state's communication methods.
- The state first attempts ex parte renewal — using data it already has to verify your continued eligibility without requiring you to submit new paperwork. If your eligibility can be confirmed this way, your coverage is renewed automatically.
- If ex parte renewal is not successful, you receive a renewal form or notice that requires you to take action. This may involve confirming your income and household information, submitting updated documents, or completing a renewal interview.
- Submit any requested documents promptly. Missing the deadline or failing to respond can result in coverage termination.
- The state makes a determination and notifies you of the outcome. If you are still eligible, your coverage continues. If you are no longer eligible, you will receive a termination notice with information about your right to appeal.
What you'll need at renewal
Be prepared to confirm or update the following at renewal time:
- Current address and contact information — Your state agency must be able to reach you. If your address has changed, update it immediately — this is the single most common reason people miss renewal notices.
- Income documentation — Recent pay stubs, tax returns, or other income verification if your income has changed.
- Household composition changes — Births, deaths, marriages, divorces, or anyone moving in or out of your household.
- Assets (for long-term care Medicaid) — If you receive long-term care Medicaid, asset documentation may be required at renewal.
The single biggest reason people lose Medicaid is failing to respond to renewal notices. Make sure your state agency has your current mailing address and contact information. Millions of people lost coverage during the 2023–2024 unwinding simply because renewal mail did not reach them.
If you lose coverage
If your Medicaid coverage is terminated — whether at renewal or at another time — you have options. Most states provide a 90-day reconsideration period during which you can submit missing information or correct errors without having to file a full new application. You also have the right to appeal any termination decision and request a fair hearing.
Losing Medicaid triggers a Special Enrollment Period for coverage through the ACA Marketplace (Healthcare.gov), during which you can enroll in a subsidized private health plan without waiting for open enrollment. For children who lose Medicaid coverage, CHIP enrollment may be available, or they may qualify for CHIP even if their parents do not qualify for Medicaid.
Don't wait for renewal — report changes right away
You should not wait until renewal time to inform your state Medicaid agency of significant changes. Changes in income, household size, residency, or other circumstances that affect your eligibility should be reported promptly — usually within 30 days of the change. Some changes can increase or reduce your eligibility immediately. Failing to report changes can result in improper payments that you may later be required to repay.