Medicaid & CHIP
Canceling a Marketplace plan when you get Medicaid or CHIP
Once you get a final determination that you're eligible for Medicaid or the Children’s Health Insurance Program (CHIP) that counts as
(or "minimum essential coverage"):
- You’re no longer eligible for a Marketplace plan with and savings on
- You should immediately end Marketplace coverage with premium tax credits or other cost savings for anyone in your household who is determined eligible for or already enrolled in Medicaid or CHIP that counts as qualifying health coverage
- If you still want a Marketplace plan after you’re found eligible for Medicaid or CHIP, you will have to pay full price for your share of the Marketplace plan without premium tax credits or other cost savings
Note: Most programs through Medicaid and CHIP count as qualifying health coverage under the health care law. If your Medicaid program doesn't count as qualifying health coverage, you may be eligible for advance payments of the premium tax credit and other savings on a Marketplace health plan, if you qualify based on your income and other factors. Find out if your Medicaid program counts as qualifying health coverage.
You may get a notice from the Marketplace
If our records show you’re enrolled in both a Marketplace plan with premium tax credits or other cost savings and Medicaid or CHIP — something we check a few times a year — you may get a notice in the mail that lists the household members who are enrolled in both kinds of coverage. The notice explains what to do next.
If you want more information about Medicaid or CHIP, or if you aren’t sure if you or others in your household are enrolled in Medicaid or CHIP, you can contact the office in your state:
If you decide to pay full price for a Marketplace plan
You can have both a Marketplace plan and Medicaid or CHIP, but you’re not eligible to receive advance payments of the premium tax credit or other cost savings to help pay for your share of the Marketplace plan premium and covered services. If you or others on your Marketplace application choose to have Medicaid or CHIP and full-price Marketplace coverage:
- End your Marketplace plan with premium tax credits if you’re the only one on the application. (If others in your household are on the same Marketplace plan, you’ll need to “report a life change” and then select that you’re enrolled in Medicaid or CHIP. When you get to the “Eligibility Results” page, continue to “Enrollment” and select a Marketplace plan for those who are still eligible for Marketplace coverage. Once you’ve confirmed your selection for the rest of the household, enrollment in a Marketplace plan with financial help will end for those who are eligible for Medicaid or CHIP.)
- Submit a new application for Marketplace coverage without premium tax credits or other cost savings. Note: You can only enroll in Marketplace coverage during the annual Open Enrollment Period or if you qualify for a Special Enrollment Period.
- Notify your state Medicaid or CHIP agency of your Marketplace enrollment. Note: You may no longer be eligible for CHIP.
Ending your Marketplace plan
Answer a few questions for step-by-step instructions on how and when to end your Marketplace plan with premium tax credits and other cost savings.