Renewing your Medicaid benefits
Each year, your state reviews whether you still qualify for Medicaid or Children’s Health Insurance Program (CHIP). Starting January 1, 2027, renewal schedules will change for most adults in the Affordable Care Act (ACA) Medicaid expansion group. Most will renew every six months, while some will continue to renew yearly.
What does this mean for you?
Your state’s Medicaid agency will review your current info to decide if you still qualify for benefits. Your eligibility is based on rules set by your state. Your state’s agency may reach out to you if they need more details from you.
Renew Medicaid for your state
If you’re an Aetna Better Health® member, you can learn more about how to renew Medicaid coverage for your state. Just choose your state from the drop-down menu to get started.
Answers to common questions
Learn what Medicaid eligibility and enrollment mean, and what to do if your eligibility changes.
What does it mean to qualify for Medicaid?
To apply for and receive Medicaid or Children’s Health Insurance Program (CHIP) benefits, you must first prove you meet certain residence and income requirements. Each state has different eligibility rules for Medicaid.
How can I find out if I qualify for Medicaid?
To learn more about how to qualify for Medicaid, check with your state’s Medicaid website. You can also visit the U.S. Department of Health and Human Services website.
What does it mean to “enroll” in or sign up for Medicaid?
Once you prove you are eligible for medical aid, you can enroll in Medicaid. In states with managed care, you can then choose a health plan (such as Aetna Better Health) to enroll in. Each state has different offerings. This process is called “enrollment” and it’s good for one year.
In most cases, you’d need to prove you’re eligible again before you can re-enroll in Medicaid for another year.
What changes could affect my Medicaid eligibility?
It’s possible to qualify for Medicaid at one point, then become ineligible or lose that coverage later. Here are a few possible reasons why that might happen:
- Earning too much money (above the income limit)
- Not reporting a change in your household or family situation (getting married, for example)
- Receiving money or assets through a gift or an inheritance
- Moving to a state with different income limits
Can my child stay covered if I no longer qualify for Medicaid?
Children and teens can stay covered as long as they still qualify for Medicaid or CHIP.
What are my options if I no longer qualify for Medicaid?
You may be able to get coverage you can afford from other options, such as:
The Affordable Care Act (ACA) marketplace
Medicare (must be age 65 or under to apply
Learn about other coverage options
- Aetna CVS Health™ ACA plans offer coverage if you’ve had a qualifying life event. To learn more, just visit the Aetna CVS Health Marketplace website.
- All other state residents: Find local help to learn about your coverage options and get help with your application.
Learn how to renew your benefits, how often you may need to renew and what steps to take.
What is Medicaid renewal?
Medicaid renewal (also called Medicaid “redetermination” or “recertification”) is when you renew Medicaid benefits. Your state will use the info they have to decide if you still qualify for Medicaid or CHIP coverage. Be sure to finish your renewal by your state’s deadline. If you don’t, you may lose your benefits.
What do I need to do to renew my Medicaid coverage?
Make sure your state Medicaid agency has your current contact info. This is very important. If you’ve changed your address or phone number, you should let your Medicaid agency know right away.
They’ll send you info and details on how to maintain your health care benefits. Be sure to open any mail you receive from your Department of Social Services or Medicaid office.
What info may my state review?
Medicaid members must report any change in income or assets (normally this is required even when it’s not renewal time). To ensure that members are still under the income and asset limits, the Medicaid agency reviews:
- Residency
- Bank accounts
- Taxes
- Income
- Pension statements
- Home equity
- Other financial documents
Note: In some states, CHIP recipients are not going through the redetermination process. Check your state’s specific redetermination plan by visiting Medicaid.gov.
Does the renewal process vary by state or specific Medicaid program?
Yes, the process is based on whichever state and Medicaid program members are enrolled in.
For instance, there are different processes for different Medicaid eligibility groups, such as:
Children
Adults under age 65
Parents and caretaker relatives
Pregnant women
People receiving supplemental security income (SSI)
Seniors age 65 and older
People with special needs requiring long-term services and support
People who need a nursing facility level of care or long-term services and support
Will I need to renew my Medicaid coverage twice a year (or every six months)?
Starting January 1, 2027, most adults in the Affordable Care Act (ACA) Medicaid expansion group will need to renew coverage every six months. Some people will still renew once a year.
Who may continue renewing Medicaid coverage once a year?
The twice-a-year coverage renewal rule generally doesn’t apply to:
- People who qualify because of age, blindness, disability, or a need for long-term services and supports
- Parents and caretaker relatives who qualify through another Medicaid group
- People who are pregnant or postpartum
- Children and people enrolled in CHIP
- American Indian or Alaska Native people enrolled in the ACA Medicaid expansion group
How can I find out which Medicaid renewal schedule applies to me?
Your state Medicaid agency decides when and how often you need to renew.
Contact your state Medicaid agency to learn whether the twice-a-year renewal rule applies to you.
What can I do if I miss my Medicaid renewal deadline or lost my Medicaid or CHIP coverage?
If you missed your state’s renewal deadline, you could still try to reapply. You may be able to come back to your previous health plan with the same providers and benefits.
If you think you’re losing your Medicaid or CHIP coverage benefits, contact your state’s Medicaid program office. They can check to see if you still qualify.