If you or someone you love depends on Medicaid for healthcare, this one’s for you. There’s a big shift happening in how Medicaid works—and it could mean the difference between getting care or getting cut off.
Starting this year, Medicaid is checking eligibility every single month for some people, instead of once a year. And no—this isn’t a glitch. It’s part of a nationwide update to ensure only qualified individuals stay on the rolls. But while the goal is accountability, the reality is that millions may lose coverage unfairly—just because they missed a letter or filled a form wrong.
Let’s break it all down, plain and simple.
Medicaid Is Now Checking Eligibility Monthly
| Topic | Details |
|---|---|
| What changed? | Monthly eligibility checks started in 2025 for certain Medicaid/CHIP recipients. |
| Who’s affected? | Immigrants, people with unverifiable status, vulnerable groups, and those who miss renewal notices. |
| Why the change? | CMS aims to improve fraud detection, eligibility accuracy, and cost-efficiency. |
| Impact estimate | Over 15–20 million Americans may be disenrolled in the coming months. |
| Main agency | CMS (Centers for Medicare & Medicaid Services) |
| Support resources | Healthcare.gov Renewal Help, LocalHelp.gov |
Look—Medicaid is a lifeline for millions of Americans. But with monthly checks now becoming the norm for some, staying informed, alert, and proactive is key to keeping your benefits intact.
Don’t assume you’re safe just because you’ve been approved before. Be your own best advocate—or help someone who might not know how. Because healthcare isn’t just paperwork—it’s people.
What’s Going On with Medicaid Eligibility Checks?
Think of it like this: imagine having to prove you’re still allowed in your apartment every month—even if nothing’s changed. Sounds exhausting, right?
That’s what’s happening with Medicaid.
In 2025, the Centers for Medicare & Medicaid Services (CMS) began requiring states to verify eligibility every month for certain groups, mainly those whose immigration or citizenship status can’t be automatically confirmed.
It’s part of an effort to “clean up the books” after the COVID-19 public health emergency, which had paused routine eligibility checks for over two years.
Who’s at Risk of Losing Medicaid Coverage First?
1. Non-Citizens & Immigration Status Not Verified
If your immigration status can’t be matched in a federal database, you’ll be flagged. It doesn’t matter if you’re here legally or not—if the system can’t confirm it, your coverage is at risk.
“I’ve lived here legally for 8 years, but my renewal notice said I wasn’t verified. It took me weeks to fix it—meanwhile, my insulin refills stopped.” — Rafael, 32, Austin TX
2. People Who Miss Renewal Deadlines
If you don’t return the form, upload the proof, or respond in time—you’re out. And not everyone even gets the notice on time.
Tip: If you’ve moved, make sure your Medicaid office has your correct address ASAP.
3. People Experiencing Homelessness or Housing Instability
Folks without stable housing may never see renewal letters or know when they’re due. Language barriers or disabilities make it even harder.
Hotline Help: Dial 211 or visit FindHelp.org for local support.
By the Numbers: Medicaid in 2025
- 97+ million Americans rely on Medicaid or CHIP.
- At least 15 million may lose coverage during eligibility unwinding, says KFF.
- 3 out of 4 people disenrolled in 2023 lost coverage for procedural reasons—not because they were ineligible.
- Some states are seeing disenrollment rates of over 50%.
State-by-State Impact Snapshot
| State | Disenrollment Rate (Est.) | Notes |
|---|---|---|
| Texas | 65%+ | Highest procedural drop rate (forms not returned). |
| Florida | 55% | Aggressive redeterminations. |
| California | 34% | Offers more lenient grace periods. |
| New York | 25% | Strong community navigator support. |
The Step-by-Step Medicaid Survival Guide
Step 1: Update Your Contact Info
- Log in to your state Medicaid portal
- Confirm your address, phone, and email
- Check every 3–4 weeks
Step 2: Check Your Mail (and Email!)
- Set calendar reminders for Medicaid deadlines
- Respond within 10 days if possible
- If you miss one, call your state agency immediately
Step 3: Gather Your Docs
- Proof of income
- Immigration or citizenship status
- Residency info (utility bill, lease, etc.)
Step 4: Apply for Marketplace Insurance if Dropped
If you’re dropped but still need coverage, you qualify for a Special Enrollment Period at HealthCare.gov
Comparison Table
| Eligibility Factor | Pre-Pandemic (Before 2020) | During the Pandemic (2020-2023) | Now (The “Unwinding” Period) |
| Eligibility Checks | Annual renewals | Mostly paused; continuous coverage | Regular, monthly renewals resume |
| Federal Support | Standard federal matching funds | Enhanced federal funding for states | Enhanced funding has ended |
| At-Risk Population | Those with changing income or household size | Minimal risk of losing coverage | Individuals with outdated contact info or who fail to respond |
| Main Action Required | Complete an annual renewal form | No action needed (in most cases) | Verify your information and respond to requests for renewal immediately |
Real Stories from the Ground
Sophia, 28, single mom in Kansas:
“I didn’t know my Medicaid ended until I tried to fill a prescription for my daughter. They said we were dropped because I didn’t send paperwork. I never got the letter.”
Jared, 61, retired construction worker in Alabama:
“They wanted me to upload my pay stubs from 2 months ago, but I don’t have a computer or smartphone.”
Top 3 Mistakes to Avoid During Medicaid Redetermination
- Mistake #1: Not Updating Your Address. Many people lost coverage because their state agency tried to mail them a renewal form at an old address.
- Mistake #2: Ignoring the Mail. The notices can sometimes look like junk mail. Don’t throw away any mail from your state’s Medicaid or Health and Human Services department.
- Mistake #3: Assuming You’re No Longer Eligible. Even if your income has changed, you might still qualify. Many people are losing coverage for “procedural” reasons—meaning they didn’t complete the paperwork—not because they are actually ineligible. Always submit your renewal form!
Common Myths—Busted!
| Myth | Truth |
|---|---|
| “I’ll get lots of warning before I’m dropped.” | Not always. You may get just one notice or none if your info is outdated. |
| “If I’m dropped, I’m out for a year.” | You can reapply or appeal immediately. Don’t wait! |
| “My benefits last all year once approved.” | Not anymore—monthly checks can change that. |
FAQs
Q: Will everyone be checked monthly now?
No. Only certain flagged individuals—mostly those with unverifiable immigration or citizenship data.
Q: Can I appeal if I’m kicked off?
Yes! Every state has an appeal process. Don’t accept the first denial—you might still be eligible.
Q: Do kids also get dropped if I lose coverage?
Often, yes—especially if your household info is tied together. Double-check CHIP eligibility options for your children.
