Lost Medicaid? What to do about the letter

A Medicaid termination notice is not the end of the story. Most people who lose coverage lose it for a paperwork reason that can be fixed — a renewal form that was never returned, a document the state says it did not get, a letter sent to an old address. Here is how to read the notice, what to do in the first week, and what your options are if you really no longer qualify.

Respond within 90 days for reinstatementFair hearing rights on every noticeMarketplace window: 60 days

Read the notice

Three things to find on the letter

The reasonNotices must say why. Common reasons: "failed to return renewal," "did not provide requested information," "income exceeds the limit," or, from October 1, 2026, a change in immigration-status eligibility. The reason decides your next step.

The end dateCoverage usually continues until a stated date. Everything below is easier if you act before that date — especially requesting a hearing.

Your rights sectionEvery notice must explain how to appeal and the deadline for asking for a fair hearing. The deadline is set by your state — at least 30 days from the notice, often 90. It is printed on the letter.

If it is a paperwork problem

The 90-day rule

If your coverage ended because you did not return a renewal form or a requested document, you have a federal safety net: return the missing information within 90 days of the end date and the state must reconsider your eligibility without a new application. If you still qualify, coverage is reinstated — in most states back to the date it ended, so bills in the gap can be covered.

Do it the fastest way your state offers — the online account or the phone line on your state's guide — and keep a record of the date you sent it. After 90 days you can still apply again; you simply start a new application.

If the state says it never received something you sent, send it again and ask for confirmation. A dated upload receipt or a fax confirmation is enough to establish that you responded on time.

If you disagree

Request a fair hearing — before the end date if you can

You have the right to a fair hearing on any denial or termination. If you request it before the end date on the notice, your coverage generally continues while the case is reviewed. Request it in writing or by phone through the method the notice describes, and say plainly that you want to keep coverage during the appeal.

At the hearing you can bring documents and a representative — a friend, a legal aid lawyer, a navigator. Common wins: the state miscounted income, treated a one-time payment as monthly, missed a household member, or did not apply an exemption. If you lose, you may owe back the cost of coverage during the appeal in some states; the notice will say.

Free help exists in every state: legal aid organizations, the state's Medicaid ombudsman where there is one, and certified navigators. Your state's guide lists the local numbers.

If you no longer qualify

Four doors that stay open

A Marketplace plan, within 60 daysLosing Medicaid is a qualifying event. You have 60 days from the end date to enroll at HealthCare.gov or your state marketplace, and if your income is above the poverty line you very likely qualify for a tax credit that lowers the premium.

CHIP for your childrenChildren qualify at much higher incomes than adults in every state. If you lost Medicaid because your income rose, your children may still be covered — ask, do not assume.

Community health centersPrimary care, prescriptions and often dental on a sliding fee scale, for everyone, regardless of coverage or status.

Hospital financial assistanceNonprofit hospitals must have a written financial assistance policy and must tell you about it. Ask for it before or after any visit; many write off most of a bill for people under 200% to 300% of the poverty line.

Questions people are asking

Plain answers

I got a letter saying my Medicaid is ending. What should I do first?Read the reason and the end date. If it is a paperwork reason — a renewal not returned, a document not received — send the missing information right away; within 90 days of the end date the state must reconsider without a new application. If you disagree with the decision, request a fair hearing before the end date so coverage continues while it is reviewed.

Can I get my Medicaid back after it was terminated?Yes, often quickly. If the reason was paperwork and you respond within 90 days of the end date, the state must reconsider your eligibility without a new application and, if you still qualify, reinstate you — usually back to the end date. After 90 days you can reapply at any time.

How long do I have to appeal a Medicaid decision?Your state sets the deadline, which must be at least 30 days from the notice date and is often 90. It is printed on the letter. To keep coverage during the appeal, request the hearing before the end date on the notice.

Does my coverage continue while I appeal?Generally yes, if you request the fair hearing before the end date on the notice and ask for benefits to continue. If you lose the appeal, some states may ask you to repay the cost of coverage during that period; the notice explains your state's rule.

I lost Medicaid because I earn too much now. What are my options?Losing Medicaid is a qualifying event for a Marketplace plan — you have 60 days to enroll at HealthCare.gov or your state's marketplace, and most people above the poverty line qualify for a tax credit. Your children may still qualify for CHIP. Community health centers and hospital financial assistance policies are available regardless of coverage.

MedicaidMatters is not a government website and is not affiliated with CMS or any state Medicaid agency. We never ask for your Social Security number, case number, or immigration documents. Every action on this page links to an official government site.

The rules are national. The numbers are local.

Your state's guide has the income table, the renewal process, the exemptions as your state applies them, and the phone number to call.

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