My health insurance or Medicaid is ending

In the United States

1. Medicaid ended, cut or refused: ask for a fair hearing before the date on the noticeTo keep your coverage going while you wait, ask for the hearing before the date of action (the day the notice says your coverage ends or is cut).United States (federal rule)

   How long

   To keep your coverage going while you wait, ask for the hearing before the date of action (the day the notice says your coverage ends or is cut). To ask for the hearing itself, your state sets a reasonable time that the federal rule caps at 90 days from the day the notice was mailed. Your state can set fewer days, so the date on your notice comes first.

   Starts

   the date printed on the notice from your state Medicaid agency. The notice also gives a date of action, the day your coverage is cut or ends. The agency has to send the notice at least 10 days before that date, except in a few cases the federal rules list. If you only have an online message, count from its date.

   If missed

   If the date of action has passed, ask for the hearing anyway, and ask in the same request for your coverage to be put back. If your notice came less than 10 days before the cut, or on or after it, ask within 10 days of the date on the notice: the agency then has to put your coverage back until the hearing decision, unless the only issue is a federal or state law or policy. Otherwise, a request no more than 10 days after the date of action means the agency may put it back. If the agency wins the hearing, it may ask you to pay back the cost of services you got only because you asked. If you think the time to ask has passed, call legal aid before you decide it has.

   It lets you

   have a hearing about the decision, and ask for it to be fast if you need it quickly. If you ask before the date of action, the agency may not cut or end your coverage until the hearing decision, unless the only issue is a federal or state law or policy. If you ask no more than 10 days after the date of action, the agency may put your coverage back until the decision.

   This is the clock for a notice that your Medicaid is ending or being cut. The same hearing right covers a refused application. If the notice says you lost Medicaid only because a form was not sent back, also use the 90-day clock below. If you can get Medicare but have not signed up, losing Medicaid opens a Medicare sign-up window: see the Part B clock.

   Where this differs: If your Medicaid ended because a renewal form or papers did not reach the office, send them now, and ask for a hearing too if you are still inside the date on the notice. If your Medicaid is based on your income, the state has to look at your eligibility again without a new application if the form arrives within 90 days of the date your coverage ended, or longer if your state allows. Medicaid is run by your state, so the notice, the form, the phone number and the exact dates are your state's. The federal rule sets the outer limit; your notice sets your date. The same hearing right covers a refused application. A state children's health insurance program or other state benefit follows its own notice: read it. If the letter is from your Medicaid health plan, not the state, it is about services, and you appeal to the plan first, by phone or in writing, within 60 days of the date on its notice. To keep a service going during the appeal, ask the plan to continue it within 10 days of the date on the notice, or before the date the change starts, whichever is later. If the plan says no, ask for the state hearing, and ask again for the service to continue, within 10 days of the plan's answer. If you lose, the plan may ask you to pay for the services you kept.

   Checked 9 October 2026 at Centers for Medicare & Medicaid Services rules, 42 CFR 431.230 (Cornell Legal Information Institute copy)

2. Medicaid renewal form: send it back by the date on itSend the form back by the date on it.United States (federal rule)

   How long

   Send the form back by the date on it. The federal rule gives at least 30 days from the date on the form, and your state can give longer.

   Starts

   the date printed on the renewal form from your state Medicaid agency, not the day it reached you. If you only have an online message, count from its date. Some states renew your Medicaid without asking you for anything: that notice says so, and you only need to answer it if something in it is wrong.

   If missed

   your Medicaid can end for not sending the form. If it ends, send the form anyway: the clock for Medicaid that ended because a form was not sent back gives a window to have your case looked at again without a new application. If the date on the notice has not passed, you can also ask for a fair hearing. You can apply again at any time of year.

   It lets you

   keep your Medicaid going without a gap and without a new application. You can send the form back online, by phone, by mail or in person, and the agency may not make you come in for an interview as part of renewal. The agency checks what you send and has to tell you its decision in a notice.

   Where this differs: This rule is written for Medicaid based on income counted the standard way (modified adjusted gross income, called MAGI). If your Medicaid is based on age (65 or older), blindness, disability or long-term care, the state may use the same steps but does not have to, so go by the date on your own form. The federal rule says a separate CHIP program uses the same renewal steps (42 CFR 457.343), and each state's CHIP works closely with its Medicaid program: read your own notice. Medicaid is run by your state, so the form, the phone number and the date are your state's. From 2027, CMS says adults in the Medicaid adult group (adults aged 19 to 64 covered because their state expanded Medicaid), and adults covered only through certain section 1115 programs, get a renewal once every 6 months instead of once every 12, for renewals scheduled on or after January 1, 2027. It does not apply to American Indians and Alaska Natives, to other Medicaid groups, or in the U.S. territories. Your state's notice gives your new date: answer each renewal by the date on it.

   Checked 10 October 2026 at Centers for Medicare & Medicaid Services rules, 42 CFR 435.916 (Cornell Legal Information Institute copy)

3. Medicaid ended because a renewal form was not sent back: send it now and ask them to look againSend the form now.United States (federal rule)

   How long

   Send the form now. The federal rule says that if you send it within 90 days after your Medicaid ended, the state must look at your case again without a new application. Your state can allow longer.

   Starts

   the date your Medicaid ended. The notice calls it the date of action: the day your coverage ends. To be safe, count from the date printed on the notice, which comes earlier. If you never got a notice, ask your state agency the date your Medicaid ended, and send the form at once.

   If missed

   you usually have to apply again with a new application. You can apply for Medicaid and CHIP at any time of year. When you apply, keep any bills from the gap and ask whether Medicaid can pay them: HealthCare.gov says it may pay for care from the last 3 months, and CMS says that from January 1, 2027, adults in the Medicaid adult group can get at most one month before the month they apply. Marketplace cover has its own window after Medicaid or CHIP ends: see the Marketplace clock.

   It lets you

   have your state look at your eligibility again without a new application, if you send in the renewal form or the information it asked for.

   Where this differs: This rule covers a person whose Medicaid ended for not sending the renewal form or the information needed. If the notice says you no longer qualify for another reason, ask for a hearing before the date on the notice (see the fair hearing clock) and apply for other cover. Medicaid based on age, blindness or disability follows the state's own steps: check your notice. Medicaid is run by your state, so the form, the number to call and the date are your state's.

   Checked 10 October 2026 at Centers for Medicare & Medicaid Services rules, 42 CFR 435.916 (Cornell Legal Information Institute copy)

4. Medicaid work requirement notice: answer it by the date on itAnswer the notice by the date on it.United States (federal rule)

   How long

   Answer the notice by the date on it. The federal rule says the state must give you 30 calendar days to show that you meet the requirement or that it does not apply to you.

   Starts

   when your state sends a notice that it could not confirm you meet the requirement or that it does not apply to you. Count from the date on the notice. States must generally start the requirement by January 1, 2027, and a state may start earlier. It applies only to some adults: see the note below.

   If missed

   your application might be denied, or you might be disenrolled (taken off Medicaid). You can apply again at any time, and your state checks the requirement again when you do. A Marketplace plan may cost more than you expect: CMS says a person who does not show the requirement and would otherwise qualify for Medicaid cannot get the premium tax credit, which is the Marketplace's savings. Ask HealthCare.gov what a plan would cost you before you pick one.

   It lets you

   show your state that you meet the requirement, or that you are exempt, and keep your Medicaid or your application going. A month meets the requirement if you work, do community service or take part in a work program for at least 80 hours; are enrolled in school at least half time; do a mix of these that adds up to at least 80 hours; or have a monthly income of at least the federal minimum wage times 80 hours.

   Where this differs: Medicaid is run by your state: its notice, its start date and what counts as proof are your state's. It applies to adults aged 19 to 64 who are not pregnant and not on Medicare, in the Medicaid adult group (adults covered because their state expanded Medicaid) or certain section 1115 programs; not in the U.S. territories. You are exempt if, for example, you are pregnant or postpartum, disabled or medically frail, a parent or caretaker of a child 13 or under or of a disabled person, American Indian or Alaska Native, a former foster youth, a veteran with a total disability rating, in drug or alcohol treatment, meeting TANF work rules, or in a household getting SNAP and not exempt from SNAP work rules. A state may also give short-term exceptions, for example after a hospital stay or a disaster in your county. Ask your state agency whether you are exempt. States check at application and at renewal, and may check more often.

   Checked 10 October 2026 at Centers for Medicare & Medicaid Services, fact sheet on the interim final rule (June 1, 2026)

5. Health cover: ask to join a work health plan through your own job, or a spouse's or parent's jobAsk the plan within 30 days of losing your cover.United States (federal rule)

   How long

   Ask the plan within 30 days of losing your cover. A plan may allow longer, but count 30 to be safe

   Starts

   the day your job-based health cover ends, whether it came through your own job or through a family member's job and ended because they died. Not sure of the date? Count from your last day of work or from the day of the death.

   If missed

   ask the plan whether its window is longer than 30 days; if not, you usually wait for its next open enrolment. The COBRA and Marketplace clocks are separate and may still be open

   It lets you

   join another group health plan you can get, such as one at your own job or a spouse's or parent's job, outside its usual sign-up time. This is sooner than either 60-day window, so check it first

   Turning 26, a divorce or a legal separation counts: the federal rule (29 CFR 2590.701-6) lists 'legal separation, divorce, cessation of dependent status (such as attaining the maximum age to be eligible as a dependent child under the plan)' as losing eligibility. Ask the plan at your own job, or at a spouse's or parent's job you can join, before your cover ends. Not sure of the date? Count from your 26th birthday, or the date of the divorce or separation.

   Checked 8 October 2026 at US Department of Labor, Employee Benefits Security Administration

6. Choose whether to keep a job-based health plan (COBRA)60 days to chooseUnited States (federal rule)

   Starts

   the later of two dates: the day the job-based cover ends (after a job loss, or after the death of the family member whose job it came through) or the day the COBRA election notice is given or mailed to you. Count from the earlier one to act in time. Do not wait for the letter: the plan has 44 days to send it, and it can be late or lost.

   If missed

   The right is gone once 60 days have passed since BOTH dates. If the notice came late or never came, your window may still be open: call the Department of Labor on (866) 444-3272. The Marketplace window is a separate clock that does not wait for this one.

   It lets you

   keep the same plan, back-dated to the day your cover ended, usually at the full premium plus 2 percent: up to 18 months after a job loss, and up to 36 months for a spouse or child after the employee's death. You have 45 days after electing to make the first payment, which may cover more than one month. If you said no, you can still change your mind within the 60 days, but cover may then start only from that day.

   If your cover is ending because you turn 26 on a parent's job-based plan, or because of a divorce or legal separation, COBRA can be open to you for up to 36 months. The Department of Labor says you or the employee must tell the plan, and the plan does not have to act until it gets proper notice. The plan's papers set the deadline, and it cannot be shorter than 60 days: tell the plan the week the change happens, the way its papers say. COBRA means paying the whole premium plus a small fee, so compare it with a Marketplace plan before you pay.

   Where this differs: If you are 65 or older or can get Medicare, ask about Medicare before choosing COBRA: COBRA without Medicare can leave you with bills. If the company closed and there is no health plan, there is usually no COBRA. COBRA covers private employers with 20 or more employees, and state and local governments; it does not cover federal-government plans or church plans. If you worked for the federal government, ask your HR office for Temporary Continuation of Coverage (TCC) on your last day: you generally have 60 days after you leave or after the TCC notice, whichever is later, to enrol. To be safe, count from the day you leave. Many states have a 'mini-COBRA' law that can reach smaller employers, with its own dates: ask your state insurance commissioner's office. Some employers agree to pay part or all of the cost in a severance package, but that is not required

   Checked 7 October 2026 at US Department of Labor, Employee Benefits Security Administration

7. Pick a health plan on HealthCare.gov after losing cover60 days to pick a plan (90 days if you lost Medicaid or CHIP)United States (federal rule)

   Starts

   the day your health cover ends, which can be later than your last day of work or the day of the death. Not sure? Count from your last day of work, or from the day of the death. You can pick a plan up to 60 days before cover ends.

   If missed

   you can enrol only in Open Enrollment (it starts November 1 each year) or after another life event. Medicaid and CHIP stay open all year. COBRA running out opens a new 60-day window; dropping COBRA or stopping payment does not.

   It lets you

   sign up outside Open Enrollment if you lost job-based cover (even if you quit or were fired), cover through a family member, or your Marketplace plan because someone on it died. Pick before your old cover ends and there is no gap; after it ends, cover starts the first of the month after you pick. If asked for proof of lost cover, send it within 30 days of picking. Cover starts only when you pay the insurer the first premium.

   If your Medicaid or CHIP ended, you may have the longer window (90 days), counted from the day it ended. If you took COBRA, HealthCare.gov says you can still switch to a Marketplace plan within 60 days of losing your job-based cover, when COBRA runs out, if your former employer stops paying its share, or in Open Enrollment. Ending COBRA early yourself does not open a new window, so check the new plan's start date before you end COBRA. Medicaid and CHIP stay open all year. If your Medicaid ended because you did not show you meet the Medicaid work requirement, you generally cannot get savings on a Marketplace plan: see the work requirement clock.

   Where this differs: Some states run their own Marketplace instead of HealthCare.gov. Use the state picker on HealthCare.gov, and check your state's site for its own dates, which may differ

   Checked 7 October 2026 at HealthCare.gov (Centers for Medicare & Medicaid Services)

8. Turning 26 on a parent's plan: ask for the exact end date, then sign up for your own coverAsk today for the exact date your cover on your parent's plan ends.United States (set by each state)

   How long

   Ask today for the exact date your cover on your parent's plan ends. A Marketplace special enrollment period starts 60 days before you lose cover on a parent's job-based plan and ends 60 days after.

   Starts

   the day your cover on the parent's plan ends. HealthCare.gov says a parent's job-based plan usually ends during or shortly after the month you turn 26: ask the plan or your parent's employer for the exact date. A parent's Marketplace plan can keep you on through December 31 of the year you turn 26. Your plan or state can set a different age or end date.

   If missed

   you may have no cover. Outside the windows, you can usually sign up for a Marketplace plan only in Open Enrollment or after another qualifying life event. Medicaid and CHIP stay open all year. If your own job offers affordable cover and you turn it down, HealthCare.gov says you generally will not qualify for the premium tax credit (a tax credit that lowers your monthly payment) or other savings on a Marketplace plan.

   It lets you

   sign up for your own cover. Your own job's plan: you can join outside its yearly sign-up if you did not take it when it was first offered and you lost your parent's cover because you turned 26, but the time can be limited, so ask your job's human resources office before you turn 26. A Marketplace plan: if you pick one before your cover ends, it can start as soon as the first day of the month after you lose cover; if you pick after, it starts the first day of the month after you pick. If you are on a parent's Marketplace plan, you pick your own plan in Open Enrollment (November 1 to January 15 each year; pick by December 15 to be covered from January 1) for the next year.

   Where this differs: HealthCare.gov says some states and plans have different rules about turning 26 and the age limit. Ask the plan or your state's Department of Insurance. If your parent has a Marketplace plan and will claim you as a tax dependent for the year after you turn 26, HealthCare.gov says to stay on your parent's Marketplace application instead of making a separate account.

   Checked 10 October 2026 at HealthCare.gov (Centers for Medicare & Medicaid Services)

9. Medicare: sign up for Part B (medical insurance) in time after job-based cover endsIf you can get Medicare, sign up for Part B before your job-based cover ends, so you have no gap.United States (federal rule)

   How long

   If you can get Medicare, sign up for Part B before your job-based cover ends, so you have no gap. The latest you can sign up without a late penalty is 8 months after your work or that cover ends, whichever happens first. Choosing COBRA does not extend the 8 months.

   Starts

   the day your job-based health cover ends or the day your work ends, whichever is first. Count from the earlier one. Medicare says the 8 months count from when you stop working or lose your insurance, whether or not you choose COBRA.

   If missed

   you may have to wait for the General Enrollment Period (January 1 to March 31 each year), and your cover then starts the month after you sign up. That can leave a gap in your cover. You may also pay a late enrollment penalty: an extra 10% on your Part B premium for each full year you could have signed up and did not, usually for as long as you have Part B.

   It lets you

   sign up for Part B without a penalty, through Social Security. Your cover generally starts the month after you sign up, so sign up about a month before your job-based cover ends to avoid a gap. You can apply online. If you apply by mail or fax in this window, Social Security asks for Form CMS-L564, the Request for Employment Information, too: you fill in Section A and your employer fills in Section B, so ask your employer for it before you leave.

   Where this differs: This window is for cover from a job (yours or your spouse's) that you or they are still working at. Medicare says COBRA and retiree cover do not count as cover from current work, so if you have only those, sign up for Part B when you are first eligible. If you are on Medicare through a disability and your cover comes from a family member other than a spouse, that employer must have a large group health plan (at least 100 employees). If you take COBRA and are eligible for Medicare but not signed up, Medicare says COBRA may pay only a small part of your bills and you may have to pay most of the costs yourself. Your COBRA will probably end once you sign up. Drug cover has its own, shorter clock: see the Medicare drug plan clock. A SHIP counselor (a State Health Insurance Assistance Program counselor, free Medicare help from your state) can help with both. If you lose Medicaid and are eligible for Medicare but not yet signed up, Medicare gives a separate window: it starts the day you are told your Medicaid is ending and ends 6 months after it ends (form CMS-10797, sent to Social Security). This window does not apply if you get Medicare because of end-stage renal disease (permanent kidney failure), or while you are still in your first chance to sign up (the 7 months around your 65th birthday): use that first window then.

   Checked 10 October 2026 at Medicare.gov (Centers for Medicare & Medicaid Services)

10. If you have Medicare: join a drug plan as soon as your job-based drug cover endsIf you have Medicare, join a Medicare drug plan as soon as your job-based drug cover ends.United States (federal rule)

    How long

    If you have Medicare, join a Medicare drug plan as soon as your job-based drug cover ends. Medicare gives you 2 full months after the month it ends, but a penalty starts if you go 63 days or more without drug cover as good as Medicare's.

    Starts

    the day your drug cover from a job ends: the job plan itself, or COBRA if you took it and it included drug cover. Not sure? Count from the day the job-based plan ended.

    If missed

    you may have to wait for another time to join, and you may pay a late enrollment penalty: an extra 1% for each month you went without creditable drug cover, added to your monthly premium for as long as you have Medicare drug coverage, even if you switch plans.

    It lets you

    join a Medicare drug plan (Part D), or a Medicare Advantage Plan, outside the usual sign-up times, if you have Medicare Part A or Part B. If you join after your Part A or Part B has started, the plan starts the first of the month after it gets your request. Your job plan has to tell you whether its drug cover is creditable (expected to pay, on average, at least as much as Medicare drug coverage): keep that letter.

    Where this differs: If you qualify for Extra Help with drug costs, Medicare says you generally do not pay this penalty. Ask 1-800-MEDICARE (1-800-633-4227, 24 hours a day except some federal holidays) or a SHIP counselor which plan fits your medicines.

    Checked 10 October 2026 at Medicare.gov (Centers for Medicare & Medicaid Services)