Medicaid & CHIP
Get Marketplace coverage if you lose or are denied Medicaid or CHIP coverage
If your state finds that your household income is too high or other items make you ineligible, you may be denied or lose your
or
coverage.
The Marketplace offers health coverage
You may be able to get Marketplace health coverage with
if you or others in your household:
- Had Medicaid or CHIP coverage, but lost it.
- Currently have Medicaid or CHIP coverage, but will lose it soon.
- Applied for Medicaid or CHIP coverage through your state agency and the state denied your application.
- Applied for coverage with the Marketplace and were found potentially eligible for Medicaid or CHIP coverage. Your state checked if you could get Medicaid or CHIP, but said you (or your household member(s)) don’t qualify.
Explore your health care options (PDF, 380 KB).
The Marketplace may contact you
When you're denied or lose Medicaid or CHIP coverage, your state securely sends your contact information to the Marketplace. We’ll use it to mail you a letter about Marketplace coverage. We may also follow up with you by phone, text, or email, if you gave that contact information to your state.
But, you don’t need to wait for us to contact you to apply and enroll in Marketplace coverage.
Local help in your community
About a month after we send you the first letter, if you haven’t enrolled in coverage, a Marketplace
in your community may contact you by phone, text, or email with the information you provided to your state Medicaid or CHIP agency.
Assisters are trained by the Marketplace to give you free, fair, impartial, and accurate information about your health coverage options, answer your questions, and help you enroll in a Marketplace plan, Medicaid, or CHIP. Assisters will:
- Never ask you for your credit card number or any other form of payment:
- Their services to help you get health coverage are free of charge.
- When you enroll in a health plan, you’ll always pay your premiums directly to the insurance company — never to the Marketplace or its assisters.
- Always provide a Privacy Notice Statement, and get your consent or “authorization” before discussing or accessing your personal information
Confirm who they are before providing any information. Ask for their name, who they work for, and their organization’s phone number, street address, mailing address, email address, and website. Write this information down. Compare it to the organization listed in the letter you got from the Marketplace.
To get help with your coverage options or to apply for Marketplace coverage, find local help near you or contact the Marketplace Call Center.
Submit a Marketplace application
Update your existing Marketplace application or create a new application right away to see if you (or other members in your household) are eligible to buy a Marketplace plan and get help with costs.
- Log into your Marketplace account. If you don’t already have a Marketplace account, you can create one.
- Start a new application, or update your existing one.
- Be sure your application includes:
- Your state’s recent decision about Medicaid and CHIP coverage.
- Information like your current income.
- Answer the Medicaid/CHIP and household questions based on your situation. (Get tips to help you answer the Medicaid and CHIP application questions under "Answering application questions.")
- Submit your completed application. You’ll get your eligibility results right away.
- Enroll in a Marketplace plan, if eligible. Once you enroll, you’ll need to pay your plan’s premium to start your coverage.
Answering application questions
Select your situation to answer questions about Medicaid and CHIP on your Marketplace application:
If you or someone in your household lost (or will soon lose) Medicaid or CHIP coverage:
- Answer “yes” to the question that asks if the person’s Medicaid or CHIP coverage has ended or will end soon. You should answer “yes” for any household member who:
- Lost Medicaid or CHIP in the past 90 days
- Will lose their current Medicaid or CHIP coverage in the next 60 days
- Lost Medicaid or CHIP or will lose Medicaid or CHIP in the next 60 days because their income went up
Then, enter the last day of the person’s Medicaid or CHIP coverage. If you don’t know the exact date, enter your best guess. Most people lose Medicaid or CHIP on the last day of the month. Answer the question that asks if your household income or size recently changed.- Answer “yes” if you’ve had a change in household income or size since your state told the person that they lost or will soon lose Medicaid or CHIP coverage. We’ll check again to find out if that person may be eligible for Medicaid or CHIP.
- Answer “no” if nothing has changed.
- Answer “no” to the question that asks if the person's Medicaid or CHIP coverage has ended or will soon end if the household member never had Medicaid or CHIP coverage.
If you or others in your household recently applied for Medicaid or CHIP and were denied (Note: this means the household member(s) didn’t already have Medicaid or CHIP coverage when they applied):
For each person in your household, answer the question that asks if the state found the person ineligible for Medicaid or CHIP in the past 90 days.
- Answer “yes” if both of the following conditions apply:
- Your state denied the person’s Medicaid or CHIP application in the past 90 days for any reason, and
- There haven’t been changes to your household income or size, or to the person’s citizenship or immigration status since your state denied the person’s Medicaid or CHIP application.
- Answer “no” if any of the following conditions apply:
- Your state denied the person’s Medicaid or CHIP application more than 90 days ago.
- Your state denied the person’s Medicaid or CHIP application within the past 90 days, but there have been changes in your household income or size, or to the person’s citizenship or immigration status since the denial.
- The person applied for Medicaid or CHIP, but your state hasn’t responded yet.
- Your state denied the person’s Medicaid or CHIP application because of a disability determination, or because the person had too many assets.
- Your state denied the person’s Medicaid or CHIP application because the person didn’t submit all the required paperwork.
If you answer “no,” we’ll check again to find out if that person may be eligible for Medicaid or CHIP.
Select “yes” for any household member who applied for health coverage through their state or the Marketplace during the dates listed in the application or if they applied with the Marketplace after a qualifying life event, like a birth, marriage or adoption.
If you already submitted a Marketplace application and told us someone in your household has special health care needs, it’s possible that your state may still be checking to see if that person qualifies for more health care services. When you review your Marketplace application, don't change your earlier answers, unless something changed since you last applied.
If you’re creating an application for the first time, be sure to tell us that someone in your household has special health care needs.
Your application results
You'll get results right away telling you if you or others in your household qualify for health coverage through the Marketplace. Based on how you answer your application questions, we may also check to see if you could still qualify for Medicaid or CHIP coverage. Review your results—they include:
- Information about savings on your Marketplace plan
- Other actions you may need to take to confirm your information
- Enrollment deadlines
Your eligibility results will also tell you if you or anyone in your household qualifies for a
to enroll outside the
, or get an earlier coverage start date. If someone in your household lost, will soon lose, or was denied Medicaid or CHIP coverage, they may qualify for a Special Enrollment Period.