If you don’t renew Medicaid, your coverage ends on the termination date printed on your notice, and every medical bill after that date becomes your responsibility until you either get reinstated or find new coverage. Federal rules give you a 90-day window after termination to send in your renewal paperwork and be reconsidered without filing a new application. If you’re no longer eligible, losing Medicaid opens a 60-day Special Enrollment Period on the Marketplace. Both clocks start the day your coverage ends, so the faster you act, the smaller the gap.
What Stops the Day Your Coverage Ends
Your Medicaid card stops working on the termination date. Doctors, hospitals, and pharmacies will not bill Medicaid for services you receive after that date. Scheduled appointments won’t be covered, and pharmacies won’t fill prescriptions under your former plan.
For anyone on ongoing medication or in the middle of a treatment plan, the disruption is immediate. Prescriptions that cost nothing under Medicaid can run tens to hundreds of dollars out of pocket at retail prices. Insulin, inhalers, and specialty drugs for autoimmune conditions aren’t optional, and the sticker shock often forces choices between medication and other necessities. Skipping doses tends to push people into the emergency room, where an uninsured visit starts in the hundreds and can exceed $10,000 once imaging, specialists, or an overnight stay are involved.
One thing worth knowing before you panic: many people who lose Medicaid aren’t actually ineligible. They just didn’t return the paperwork. That’s called a procedural termination, and it’s the easiest kind to fix.
The 90-Day Reconsideration Window
Federal rules require every state to accept a late renewal form for up to 90 calendar days after termination and process it without making you start a new application.1eCFR. 42 CFR 435.916 – Regularly Scheduled Renewals of Medicaid Eligibility Some states give you longer, but 90 days is the federal floor everywhere.
During reconsideration, the state treats your renewal form the way it would treat an application. If you’re found still eligible, some states reinstate coverage retroactively to the termination date, closing the gap entirely. Others restart coverage from the date you submitted the paperwork. Either way is faster and simpler than reapplying from scratch.
This lifeline only works for procedural terminations. If the state already determined you’re over the income limit or otherwise no longer eligible, sending the form back in won’t change that outcome — you’ll need a different plan.
Appealing a Termination You Think Is Wrong
If you believe the state got it wrong, you can request a fair hearing. You have up to 90 days from the date the termination notice was mailed to file the request.2GovInfo. 42 CFR 431.221 – Request for Hearing
When you file matters as much as whether you file. Request the hearing before the termination date on your notice, and the state generally cannot cut off your benefits until a decision is reached. Your coverage continues through the entire appeal.3eCFR. 42 CFR 431.230 – Maintaining Services Wait until after the termination date, and you can still get a hearing, but your coverage won’t continue while it plays out.
One risk to weigh: if the hearing goes against you, the state can seek to recoup the cost of benefits you used during the appeal. In practice, this rarely turns into collection action for routine care, but it’s worth understanding before you rely on continued benefits for an appeal you’re unlikely to win.
Paying for Care During a Gap
If you end up needing care while uninsured, two protections can bring the bill down.
Hospital Financial Assistance
Nonprofit hospitals are required by federal tax rules to maintain a written financial assistance policy offering free or discounted care to eligible patients. The policy must be publicized in emergency rooms, on billing statements, and on the hospital’s website.4eCFR. 26 CFR 1.501(r)-4 – Financial Assistance Policy and Emergency Medical Care Policy
Criteria vary by hospital, but many extend charity care to patients earning up to 200% or even 400% of the federal poverty level. For 2026, the poverty level for a single person is $15,960, so you can qualify at incomes well above that.5Federal Register. Annual Update of the HHS Poverty Guidelines Ask the billing department for a financial assistance application before assuming you owe the full amount. Hospitals cannot charge financial-assistance-eligible patients more than the amounts generally billed to insured patients for the same care.
The Three-Month Medicaid Lookback
When you’re approved for Medicaid, the state must cover services you received during the three months before your application month, as long as you would have qualified at the time.6Office of the Law Revision Counsel. 42 USC 1396a – State Plans for Medical Assistance Reapply in July and get approved, and Medicaid can pay for covered services from April, May, and June. If bills piled up during the gap, this can retire them.
Reapplying After the 90 Days
Miss the reconsideration window and you’ll need to submit a new application. States accept applications through the Medicaid agency website, by phone, by mail, or in person at a local social services office. Have proof of income (recent pay stubs or tax returns), verification of your address and household, and documentation of citizenship or immigration status ready.
Processing is often faster than people expect. Nationally, about two-thirds of income-based applications are processed within seven days, and some states finish them in under 24 hours.7Medicaid.gov. Medicaid MAGI and CHIP Application Processing Times Applications that turn on disability or other non-income factors take longer, sometimes 45 days or more.
Switching to a Marketplace Plan
Losing Medicaid triggers a Special Enrollment Period on Healthcare.gov (or your state’s marketplace). You have 60 days from the date you lost coverage to pick a plan.8Medicaid.gov. Temporary Special Enrollment Period for Consumers Losing Medicaid or CHIP Coverage Coverage starts the first day of the month after you select the plan, so a June 10 selection means a July 1 start date.9CMS. When Would Marketplace Coverage Start for Consumers with a Medicaid or CHIP Denial SEP
Premium tax credits still reduce your monthly cost based on income. The enhanced credits that ran from 2021 through 2025 expired at the end of 2025, and 2026 premiums are significantly higher as a result. Plans that used to cost some enrollees under $10 a month will cost substantially more. When you apply, you’ll see your exact subsidy and plan prices before you commit.10IRS. Eligibility for the Premium Tax Credit
Miss the 60-day window and you’ll generally wait until the next open enrollment in the fall. That can mean months uninsured.
Other Coverage Paths
The Marketplace isn’t the only option. Depending on your household:
- If you or a family member has access to a job-based plan, losing Medicaid qualifies you for a special enrollment there too. Employers usually cover a significant share of the premium.
- Children in families with incomes too high for Medicaid but too low for private insurance may qualify for CHIP, which has higher income limits than Medicaid in every state.11Medicaid.gov. CHIP Eligibility and Enrollment
- If you recently left a job with employer coverage, COBRA can continue that plan for up to 18 months (36 months for certain qualifying events like divorce). You pay the full premium plus a 2% administrative fee, which often runs several hundred dollars a month. Compare it against a Marketplace plan before enrolling; subsidies frequently make the Marketplace cheaper.12U.S. Department of Labor. FAQs on COBRA Continuation Health Coverage for Workers
What to Do Right Now
If a renewal notice is sitting on your counter and you haven’t responded, respond today even if the deadline has technically passed. You’re almost certainly still inside the 90-day reconsideration window, and the state must process your renewal without a new application.1eCFR. 42 CFR 435.916 – Regularly Scheduled Renewals of Medicaid Eligibility
If coverage has already been terminated and you believe the termination was wrong, request a fair hearing quickly. Filing before the effective date on your notice keeps benefits on during the appeal.
If you’re past the 90 days and no longer eligible, apply for Marketplace coverage within 60 days of the termination date so the gap doesn’t stretch until fall open enrollment. Keep every termination notice and piece of correspondence from your state Medicaid agency. Those documents prove the coverage loss date, which you’ll need for Marketplace enrollment and for any financial assistance applications at hospitals or clinics.