Your Medicaid Plan May Change, But Your Strategy Won’t: A Simple 3-Step Annual Review to Protect Your Coverage

Medicaid requires annual reviews of eligibility to make sure recipients still qualify. According to the Centers for Medicare & Medicaid Services (CMS), states must conduct these renewals each year and may use “ex parte” (automatic) reviews when possible, but sometimes you need to submit forms to confirm continued eligibility.

Many people lose coverage for avoidable administrative reasons. “A renewal notice sent to an old address, a form returned a week late, or a missing document can trigger an automatic cutoff,” Lee explains. “These aren’t policy decisions; they’re paperwork problems — and they fall hardest on people juggling multiple jobs, caregiving responsibilities or housing instability.”

State‑level examples to help illustrate the process

South Carolina: “South Carolina Healthy Connections Medicaid must be renewed every year.” When you get your review form, make sure your contact info is up to date, complete the form fully and return it by the due date. According to SCDHHS:

If you don’t return the form by the deadline, we will send a notice to let you know the date when your Medicaid will end.

Vermont:  According to the Department of Vermont Health Access, “If the State of Vermont has enough information on file, some people will have their Medicaid coverage renewed automatically. In some situations, we will need to ask you for information about yourself and your family.” The state notes that renewal notices may come in an envelope with a red stripe and emphasizes:

If you do not return your renewal or send us documents by the due date, your Medicaid coverage will end.

California (Medi‑Cal): According to the Medi‑Cal Eligibility Division, the redetermination process begins with an “ex parte review of all available information,” and only if that fails do counties send a renewal packet. As stated in Info Letter No. I 25‑12:

If ex parte is not successful…counties must send the Medi‑Cal member(s) an annual renewal form.

Ignoring the annual review could result in a temporary loss of coverage, even if you still qualify. Each state may have slightly different requirements, so it’s best to check local resources for more information.

Step 1: Gather your info and updates

Before you start the review, collect any relevant documents and information:

• Recent income statements or pay stubs
• Household size and dependent information
• Address or contact updates
• Any other insurance coverage

Even if nothing has changed, reviewing your information ensures your state has accurate records and can prevent delays or gaps in coverage. “Make sure your state Medicaid office has your current mailing address, phone number, and email — not just your health plan,” Lee explains. “Those systems don’t always talk to each other. Renewal packets are time-sensitive, and returning them early gives you time to fix any issues before they cause a lapse.”

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Step 2: Confirm your renewal notice and action items

Once you receive your renewal notice, carefully check what’s required:

• Some states automatically renew coverage if nothing has changed
• Others require a form to be submitted online, by mail or by phone

Set a calendar reminder to respond by the deadline. Don’t assume auto-renewal will cover everything.

Step 3: Review your plan and act if changes are needed

After confirming your renewal, take a few moments to review your actual coverage:

• Benefits and services included
• Provider networks and access to preferred doctors
• Any cost-share changes

Checklist for this step:

1. Did my coverage renew successfully?
2. Did any benefits or providers change?
3. If my coverage ends, what are my next options?
4. Are there upcoming deadlines I need to meet?

Following these steps each year ensures that your strategy (check, confirm and act) remains effective, even if your plan itself changes.

If your coverage is ending

“Act immediately,” Lee says. “Ask for the reason in writing and whether you can keep your coverage active while the state reviews any missing information—  many states allow this. And if you no longer qualify, look right away at Marketplace plans. Losing Medicaid opens a special enrollment window, and many people find zero-premium options they didn’t realize were available.”

If your household or income changed and you no longer qualify for the same plan, you can explore alternatives such as state marketplace plans, other assistance programs or Medicare Supplement coverage to help fill gaps in your benefits.

Even if your plan looks unchanged, don’t skip your annual review. Keeping your documents organized, checking your state portal and setting reminders can prevent gaps in coverage. Bookmark your state’s Medicaid renewal page and make this 3-step annual review part of your yearly routine.

If you’re also enrolled in Medicare or considering supplemental coverage, it’s a good idea to compare plans each year to make sure your benefits meet your needs.