Yes, there are cases in which you can be dropped from Medicaid, and it can be abrupt. Medicaid has very strict requirements that relate to income and household size, as well as working hours. Every state is slightly different, but here are some good rules of thumb to follow.
Medicaid Is Evaluated Monthly
Losing Medicaid eligibility can be shocking if it happens to you. It may feel like the rug has been pulled out beneath your feet. What you need to understand is that Medicaid qualifications are reevaluated monthly, and if anything changes to your income or work situation during that month may affect your eligibility.
One case in which people find themselves on Medicaid is if they have lost their job and are now on unemployment insurance. Generally, if someone has been unemployed and getting unemployment, and their family is of a certain size, then they, or at least some of their family members, will qualify for Medicaid. However, if that person takes on extra work, even something that just pays a few hundred dollars more than they’re making in unemployment, it can kick them out of Medicaid eligibility.
Note that this doesn’t always apply to everyone in the family. Often, the adults in the family will be dropped from Medicaid, but the children will still be eligible, or a pregnant mother would still be eligible. It can really vary from situation to situation.
Just don’t be surprised if you have been earning a little more than usual and you get a letter in the mail fairly quickly that says you’re no longer eligible for Medicaid.
What is Medicaid Eligibility? When Does Medicaid End?
Medicaid eligibility and health coverage are determined state-by-state, with different states having different requirements. All of the states have an equation that they use which calculates the upper limit in household income for the number of people in the household, and if you cross that state’s Medicaid threshold, you could be dropped from eligibility.
Some states, per a 2018 amendment to the law, have put into effect working requirements that may require Medicaid program recipients to work as much as 20 hours per week to remain eligible. Though these requirements vary from state to state, they will never apply to those older than 65, pregnant women, people who are legally disabled, and children.
To determine your Medicaid eligibility, contact your local Department of Health and Human Services, or Healthcare.gov for more resources.
You may be asking “I don’t qualify for Medicaid. Now what?” We can help.