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Losing Medicaid? Here's What It Means for Your Medicare Coverage in 2026

## **Important Disclaimer:** *This information is for educational purposes only and does not constitute marketing of any specific Medicare plan. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. This material is not affiliated with or endorsed by the federal Medicare program.*

**Losing Medicaid in 2026? Here's What It Means for Your Medicare Coverage**

**Quick Answer:** If you have both Medicare and Medicaid and you lose your Medicaid coverage, your Medicare does not automatically disappear — but your costs will go up, sometimes significantly. If you lose Medicaid coverage and are enrolled in a Dual Special Needs Plan (D-SNP), your plan may continue to provide coverage for a period of time — between 30 days and six months depending on the plan — while you work to restore your eligibility. This guide explains exactly what happens, what it costs, and what to do right now — in plain language.

If you're worried about losing your Medicaid right now, you are not alone. On July 4, 2025, the "One Big Beautiful Bill Act" was signed into law, cutting federal funding for Medicaid by approximately $1 trillion over 10 years. The nonpartisan Congressional Budget Office estimates that these cuts will result in 11.8 million individuals directly losing their health insurance coverage under Medicaid.

The fear is real. But so is the information that can protect you. Let's walk through this together.

**Why People Are Losing Medicaid in 2026**

Medicaid redetermination in 2026 is entering a new phase. Under the One Big Beautiful Bill Act signed into law, states must now conduct eligibility redeterminations every six months — instead of every 12 months — for Medicaid expansion populations starting December 31, 2026. Combined with new work requirements and stricter verification rules, an estimated 7 to 10 million additional people could lose Medicaid coverage over the coming years.

Here's the timeline of what's happening and when:

Starting in 2026, several provisions took effect that further reduce access to Medicaid. On January 1, 2026, the law sunsets the enhanced federal matching funds that had incentivized states to expand Medicaid under the Affordable Care Act.

By December 31, 2026, states will also be required to conduct Medicaid eligibility redeterminations at least once every six months, adding new administrative burdens that are expected to push more people off the rolls — even those who remain eligible.

Beginning in January 2027, most Medicaid recipients will need to meet work requirements of 80 hours per month through employment, training, or volunteer activities to maintain their coverage.

Starting January 1, 2027 (or earlier if your state opts in), non-exempt adults ages 19 to 64 in the Medicaid expansion group must work 80 hours per month. If you do not meet this requirement and are not exempt, you will receive a notice and have 30 days to respond before losing coverage.

**The Critical Protection: Who Is Exempt**

Here is the most important thing to understand — and it's genuinely reassuring if you have both Medicare and Medicaid.

While the broad health care cuts affect many Medicare beneficiaries — including those who are dually eligible — the work requirements target certain adults. Importantly, people who are dually eligible for both Medicare and Medicaid are not subject to the new work requirements. The work and community engagement requirements are aimed at the Medicaid expansion population of non-elderly adults who are not enrolled in Medicare.

However — and this is where we need to be honest with you — starting on December 31, 2026, all states must conduct eligibility redeterminations for expansion individuals every six months. More frequent redeterminations significantly elevate the risk of procedural disenrollments despite enrollees remaining eligible, and increase the rate of churn which interrupts continuity of care.

In plain language: even if you are legally protected from work requirements, the system strain from processing millions of redeterminations means paperwork errors and missed notices can cause coverage loss for people who genuinely still qualify. Many people lose coverage simply because renewal notices go to an old address. Staying vigilant is your real protection.

**The Most Common Reasons People Lose Medicaid**

Rising income is the most common reason people lose Medicaid. Medicaid coverage typically ends at the close of the month in which you're found ineligible — whether that's because your income climbed too high, you didn't respond to an annual renewal notice, or your household circumstances changed.

Other common reasons include:

• Missing or not responding to a renewal notice
• A change in household size or living situation
• Failing to provide required documentation on time
• Moving to a new address and not updating your information
• In 2027 and beyond — failing to meet new work reporting requirements (if you are in the expansion population and not on Medicare)

Your state will give you at least 10 days' written notice before cutting off benefits, and you have the right to appeal and keep coverage running while you fight the decision.

**What Happens to Your Medicare If You Lose Medicaid**

This is the question that matters most. The answer depends on what type of Medicare coverage you have.

**If You Have Original Medicare (Parts A and B)**

Your Medicare coverage itself does not go away. Medicare and Medicaid are separate programs, and losing one does not automatically cancel the other.

But what changes immediately is who pays your costs. When you had Medicaid, it was covering your Medicare premiums, deductibles, and copays. Without it, those costs fall back to you:

• **Part B premium:** $202.90 per month in 2026 — which may now come directly out of your Social Security check
• **Part A deductible:** $1,736 per benefit period in 2026 — no longer covered by Medicaid
• **20% coinsurance** for doctor visits and outpatient services — now your responsibility
• **Part D costs:** Your Extra Help (Low-Income Subsidy) status may be affected (more on this below)

Even if your assets make you ineligible for a Medicare Savings Program, you could still enroll in Original Medicare or a zero-premium Medicare Advantage plan and pay just $202.90 per month in premiums in 2026.

**If You Have a Dual Special Needs Plan (D-SNP)**

This is where things get more complicated — and where the grace period matters most.

D-SNPs are Medicare Advantage Plans designed to meet specific care needs, and you can only join one if you fit the special needs category the plan serves. A D-SNP may serve people who have both Medicare and Medicaid. If you lose Medicaid coverage, the D-SNP may continue to provide coverage for a period of time if it seems likely that you will regain eligibility. Depending on the plan, you may have between 30 days and six months to regain eligibility.

This is called the **deeming period** — and here is what it means in plain language:

• Your D-SNP keeps you enrolled temporarily while you work to get Medicaid back
• D-SNPs are not responsible for coverage of Medicaid benefits during a period of deemed eligibility. Cost-sharing amounts for Medicare basic and supplemental benefits do not change during this period, and the D-SNP enrollee may be billed the cost-sharing included in its bid for the contract year.
• In other words: you keep your plan's network and doctors, but you start paying the Medicare cost-sharing that Medicaid was covering before
• If the enrollee of a D-SNP does not re-qualify within the plan's period of deemed continued eligibility, the D-SNP must involuntarily disenroll the individual with proper notice at the end of this period. The organization should provide the individual with a minimum of 30 days' notice.

**The bottom line:** The deeming period is your window. Use it to reapply for Medicaid or a Medicare Savings Program before it closes.

**What Happens to Your Prescription Drug Coverage**

This is one of the least-understood consequences of losing Medicaid, and it can hit your wallet hard.

If you had full Medicaid, you automatically qualified for **Extra Help** (also called the Low Income Subsidy), which in 2026 means no drug plan deductible and copays capped at $5.10 for generics and $12.65 for brand-name drugs.

When you lose full Medicaid, your automatic Extra Help status may end. What that means:

• Your drug plan deductible could return — up to $590 in 2026 for standard Part D plans
• Your copays for medications could rise significantly
• If you go 63 days or more without creditable drug coverage, the Part D late enrollment penalty clock could start — a permanent premium increase

**The important exception:** avoiding late enrollment penalties is critical in this transition. If you qualify for both Medicare and Medicaid, you may remain dually eligible, with Medicaid covering premiums and services that Medicare doesn't, like long-term care and dental. Even if you lose full Medicaid, you may still qualify for a Medicare Savings Program — and MSP enrollment automatically qualifies you for Extra Help on prescriptions.

**Your Special Enrollment Period: The Window You Must Not Miss**

If you lose Medicaid coverage and you're eligible for Medicare, you may qualify for a Medicare Special Enrollment Period (SEP) — a limited window outside of the traditional Medicare enrollment periods during which eligible individuals can change their coverage.

There are two potential situations where an SEP would apply: you had Medicaid coverage when you first became eligible for Medicare but did not sign up for Medicare during your Initial Enrollment Period; or you had both Medicaid and Medicare coverage at the time you lost your Medicaid coverage.

Here's how each works:

In the first scenario — where you missed your Initial Enrollment Period — you may qualify for a 6-month SEP that starts after your Medicaid coverage ends, during which you can enroll in Medicare Part A, Part B, or both.

In the second scenario — where you had existing Medicare coverage — you may qualify for an SEP that lasts 3 months from the later of two dates: when you lost eligibility or when you were notified of the loss of eligibility.

**This window is critical.** Missing your SEP can leave you waiting until the General Enrollment Period (January 1–March 31), with coverage not starting until July 1 — and a potential late enrollment penalty added permanently to your premium.

**What to Do Right Now: A Step-by-Step Action Plan**

Whether you've already lost Medicaid, just received a notice, or are worried it might happen, here is your action plan.

**Step 1: Update your contact information immediately**

Log in to your state Medicaid portal or call your local office. Make sure your mailing address, phone number, and email are current. Many people lose coverage simply because renewal notices go to an old address.

**Step 2: Watch for and respond to your renewal notice**

Your state will send a renewal packet by mail, and many states also send notices electronically. Respond as soon as you receive it. Do not set it aside — deadlines are firm and extensions are not guaranteed.

**Step 3: Gather your documents before you need them**

You will typically need proof of income (pay stubs, tax returns, or a letter from your employer), proof of identity, proof of residency, and Social Security numbers for household members. Having these ready means you can respond instantly when a notice arrives.

**Step 4: If you receive a termination notice, appeal it**

Your state will give you at least 10 days' written notice before cutting off benefits, and you have the right to appeal and keep your coverage active while the appeal is reviewed. Don't assume a termination is final — appeal first, then gather documentation.

**Step 5: Immediately apply for a Medicare Savings Program**

Even if you don't qualify for full Medicaid, you may qualify for a Medicare Savings Program that covers your Part B premium ($202.90/month in 2026) and potentially more. This also restores your Extra Help for prescription drugs. Contact your state Medicaid office as soon as possible.

**Step 6: If you're in a D-SNP, act during the deeming period**

Your plan has given you a grace window of 30 days to six months. Use every day of it. If you can restore Medicaid eligibility before the deeming period ends, your D-SNP enrollment continues without interruption.

**Step 7: If you cannot restore Medicaid, use your Special Enrollment Period**

If you've lost Medicaid coverage and wish to modify your existing Medicare coverage during your SEP, review your coverage options on the Medicare website and speak with a Medicare representative by phone at 800-633-4227. For unbiased guidance, consider contacting your local State Health Insurance Assistance Program (SHIP).

**If You Can't Get Medicaid Back: Your Coverage Options**

Losing Medicaid doesn't mean losing all coverage. Here are your realistic options:

**Option 1: Medicare Savings Program** Even if full Medicaid is out of reach, an MSP can cover your Part B premium and sometimes more. The QMB program covers all Medicare cost-sharing. Income and asset limits are more generous than you might expect — and your home, car, and personal belongings don't count as assets.

**Option 2: Zero-premium Medicare Advantage** Depending on your circumstances, you might choose to enroll in a Medicare Advantage plan that provides prescription, dental, and vision coverage and caps enrollees' annual out-of-pocket costs for Parts A and B. Many of these plans are available with no additional premiums, which means you'd pay just $202.90 per month for your Part B coverage in 2026.

**Option 3: Apply for Extra Help separately** Even if you don't qualify for Medicaid or an MSP, you may still qualify for Extra Help on prescription drugs through Social Security. Call 1-800-772-1213 to apply.

**Option 4: Reapply for Medicaid** Families who lose Medicaid specifically because someone in the household started earning more or working more hours may qualify for Transitional Medical Assistance, which extends coverage for up to 12 months. The extension breaks into two six-month periods, and during the first six months, continued coverage is automatic regardless of how much your earnings grow.

**Frequently Asked Questions**

**If I lose Medicaid, do I lose my Medicare too?**

No. Medicare and Medicaid are separate programs. Losing Medicaid does not cancel your Medicare. What changes is who pays the costs Medicare doesn't cover — premiums, deductibles, and copays that Medicaid was picking up will now fall to you. Your Medicare coverage itself stays intact.

**Am I subject to the new Medicaid work requirements if I have both Medicare and Medicaid?**

No. People who are dually eligible for both Medicare and Medicaid are not subject to the new work requirements introduced in 2026. The work requirements target the Medicaid expansion population of non-elderly adults who are not enrolled in Medicare. However, the more frequent redetermination schedule (every six months starting December 31, 2026) applies more broadly — so staying on top of your renewal paperwork is essential even if you're exempt from work requirements.

**What is the deeming period and how long do I have?**

The deeming period is a temporary window — between 30 days and six months depending on your D-SNP plan — during which your Dual Special Needs Plan keeps you enrolled after you lose Medicaid, while you work to restore eligibility. During this period, your Medicare benefits continue through the plan, but you become responsible for the cost-sharing that Medicaid was covering before. If you restore Medicaid before the deeming period ends, your coverage continues without interruption.

**What happens to my prescription drug coverage if I lose Medicaid?**

Your automatic Extra Help (Low-Income Subsidy) status may end when you lose full Medicaid, which means your drug plan deductible could return (up to $590 in 2026) and your copays for medications could rise significantly. However, if you qualify for a Medicare Savings Program, that automatically restores your Extra Help status. Apply for an MSP as soon as possible to protect your drug coverage.

**How long do I have to make changes to my Medicare after losing Medicaid?**

If you had both Medicare and Medicaid when you lost Medicaid coverage, you typically have a 3-month Special Enrollment Period starting from the later of two dates: when you lost eligibility or when you were notified. If you missed your Initial Enrollment Period because you had Medicaid, you may have a 6-month SEP. Don't wait — missing this window means waiting for the General Enrollment Period and potentially facing a late enrollment penalty.

**What if I lost Medicaid because of a paperwork error or missed notice?**

Appeal immediately. Your state must give you at least 10 days' written notice before terminating coverage, and you have the right to appeal and keep your coverage active while the appeal is reviewed. Many coverage losses are reversed on appeal — especially when the loss was due to a missed notice, an address error, or a documentation mix-up. Contact your state Medicaid office or your local SHIP for help filing the appeal.

**Can I get Medicaid back once I've lost it?**

Yes, in most cases. If your circumstances change — income drops, household size changes, or you meet a new eligibility pathway — you can reapply at any time. If you lost coverage because of increased earnings, you may qualify for Transitional Medical Assistance, which extends coverage for up to 12 months while you get back on your feet. And if your state expands its eligibility rules going forward, you may qualify under updated criteria even if you were denied before.

**The Bottom Line: You Have More Protection Than You May Think**

Losing Medicaid is frightening — especially when you depend on it to cover the costs Medicare leaves behind. But it is not the end of your coverage story, and for most people with both programs, there are real protections in place.

If you are dually eligible, the work requirements do not apply to you. Your D-SNP has a deeming period that gives you time to fight back. Your Special Enrollment Period gives you a window to adjust your Medicare coverage. And Medicare Savings Programs exist specifically to step in when full Medicaid is out of reach.

The people who are most at risk are the ones who don't know these protections exist — or who give up when a termination notice arrives without realizing they can appeal. You now know. Use that knowledge.

The single most important step you can take today is this: **make sure your state Medicaid office has your current mailing address.** More coverage is lost to missed notices than to actual ineligibility. That one simple action protects everything else.

**Need Additional Help?**

If you are losing or have lost Medicaid and need guidance on your Medicare options:

• **Call 1-800-MEDICARE** for help understanding how losing Medicaid affects your Medicare coverage
• **Visit Medicare.gov** to review your coverage options and use the Plan Finder tool
• **Call Social Security at 1-800-772-1213** to apply for Extra Help on prescription drug costs
• **Contact your state Medicaid office** to appeal a termination, reapply, or check your eligibility for a Medicare Savings Program
• **Contact your local SHIP** (State Health Insurance Assistance Program) for free, unbiased, one-on-one counseling — they know your state's specific rules and can walk you through every option

**Required Compliance Disclaimers:**

*For agent use only. Not affiliated with the U.S. federal government or federal Medicare program. This information is provided for educational purposes only and does not constitute marketing of any specific Medicare plan.*

*For official Medicare information, please visit Medicare.gov or call 1-800-MEDICARE. You can also contact your local State Health Insurance Program (SHIP) for personalized assistance.*