Medicaid Renewal: How to Keep Your Coverage

Medicaid eligibility is not permanent. Federal rules require every state to redetermine each enrollee's eligibility at least once every 12 months. Some renewals happen automatically, called an ex parte or passive renewal, where the state checks your income and household information against data it already has on file (wage records, tax data, other benefit programs) and renews you without asking you to do anything. When the state cannot verify your eligibility that way, it mails, texts, or posts a renewal packet to your portal account with a deadline, usually 30 days from the date it is sent. Miss that deadline and your coverage can be terminated even if you are still fully eligible: a procedural termination, not a real change in your circumstances.

Ex parte renewal is the process states are required to try first. Under a federal rule that took effect June 3, 2024, a state must attempt to renew your Medicaid using reliable information it already has (state wage databases, the IRS, SNAP or TANF records, and other verified sources) before it asks you for anything. If that data confirms you still qualify, the state renews your coverage and sends you a notice. You do not have to fill anything out. How often this actually happens varies enormously by state. During the 2023 unwinding period, the Kaiser Family Foundation found that 55% of renewals nationally were completed through ex parte review, with North Carolina completing 99% of renewals this way and Wyoming completing only 3%. Your state's renewal packet, portal, or the phone number on your Medicaid card will tell you whether you were renewed automatically or still owe paperwork. Check the portal even if you have not received mail: a notice can post online before or instead of a mailed letter.

If your coverage ends because you did not return a renewal form or requested document, that is a procedural termination, and federal law gives you a second chance. Under the same 2024 CMS rule, if you submit the missing renewal form or information within 90 days of the termination date, the state must redetermine your eligibility using that information and cannot make you file a brand-new application. If you are found eligible, coverage is reinstated back to the date it was cut off, so any care you got in the gap is still covered. This window applies to people whose eligibility is based on income, the category (called MAGI Medicaid) covering most adults, parents, and pregnant people. States must extend the same 90-day window to people whose eligibility is based on age, blindness, or disability by June 3, 2027.

A 2024 JAMA Internal Medicine study tracked who actually loses Medicaid during renewal and found the losses are not evenly spread. Black adults were about twice as likely as white adults to report losing Medicaid because they could not complete the renewal process, not because they stopped qualifying: an adjusted odds ratio of 2.19. Black enrollees made up 16.4% of the Medicaid population studied but accounted for 22.0% of people who lost coverage over an incomplete renewal. That gap is a paperwork and outreach failure, not a reflection of who actually still qualifies. Two things close it from your end: confirm the state has your current mailing address, phone number, and email before your renewal window opens, and check your Medicaid portal every few months instead of waiting for mail that can be delayed, misrouted, or sent to an old address.

Most states ask for the same core documents at renewal, whether you are renewed automatically or asked to respond. Have these ready: proof of current income (recent pay stubs, a benefits award letter, or your most recent tax return), proof of address if you have moved, and the names, dates of birth, and Social Security numbers of everyone in your household whose income counts toward your case. If your household changed (a new baby, someone moved out, a change in income) report it as soon as it happens rather than waiting for the renewal date. An outdated household record is one of the most common reasons a renewal gets flagged for manual review instead of passing ex parte. Keep a photo of every document you submit along with the confirmation number or date you submitted it. If your state's renewal packet references a document you do not have, call the number on the packet and explain rather than leaving the item blank; caseworkers can usually accept an alternative.

Renewal deadlines, portal names, and documentation rules are set by each state's Medicaid agency, not by a single federal system. This site maintains a renewal guide for every state, including Georgia, Texas, Florida, North Carolina, and Ohio, with your state agency's name, renewal portal, and phone number. Find your full state list at the Medicaid by state hub.

Renewal is about to get more frequent for some adults. Under the tax and spending law signed in 2025 (H.R. 1, also called OBBBA), most adults who qualify for Medicaid through ACA expansion must start renewing every six months instead of once a year, and many will also have to report at least 80 hours a month of work, school, job training, or community service to stay enrolled. States must implement the new rules by January 1, 2027, though federal guidance took effect July 31, 2026 and a few states started sooner. Several groups are excluded outright, including pregnant and postpartum people, caregivers of a child 13 or younger or a disabled family member, medically frail enrollees, and people already meeting SNAP or TANF work rules. If you qualify through ACA expansion, expect your next renewal notice to say whether the new schedule applies to you.