Medicaid renewal is the yearly recheck that decides whether your coverage continues. Every state runs it on the same federal frame: your eligibility is redetermined once every 12 months, the agency has to try to renew you from data it already has before it sends you any paperwork, and if it does need paperwork you get at least 30 days from the date on the form to return it (required for MAGI-based coverage; a state option otherwise). What changes from state to state is the portal, the agency name, and the managed-care plan behind your card, not the rules underneath. This guide walks through the federal renewal framework step by step, then points you to your state's specifics.

In This Guide

Key Takeaways

How the Medicaid Renewal Cycle Works

Medicaid eligibility is not permanent. Federal rules at 42 CFR 435.916 require a state agency to redetermine each enrollee's eligibility on a regular schedule. For most groups that schedule is once every 12 months, and it stays 12 months for everyone outside the ACA expansion adult group even after the 2027 change described below. The clock runs from your last determination, so your renewal month is tied to when you were approved, not to January or to a single statewide date.

Two things happen at renewal. The agency confirms you still meet the financial rules for your eligibility pathway (income, and for some groups an asset test), and it confirms the non-financial facts, such as state residency and citizenship or satisfactory immigration status. If everything still lines up, your coverage continues for another 12 months. If it can't confirm something, the agency has to ask you, and that is where the renewal packet comes in.

The word "recertification" on some states' notices and "redetermination" in the federal rules describe the same event: the annual recheck.

What Happens Before You Get Any Paperwork

The single most important renewal rule is one most people never see happen. Before a state can ask you for a form, it must first try to renew you automatically, using information it already has. This is called an ex parte or automatic renewal, and it is the federal default under 42 CFR 435.916(b)(1): the agency must redetermine eligibility without requiring anything from you when it can do so from reliable data in your file or from electronic sources it can check, such as wage and benefit databases.

When the automatic renewal succeeds, the agency sends a notice telling you it renewed your coverage and what it based that on. You don't have to sign or return anything if the information on the notice is accurate. Only when the agency cannot confirm eligibility this way is it allowed to move to the next step and request information from you.

One group sees fewer automatic renewals. People who qualify on the basis of being aged, blind, or disabled fall under a resource test, and federal law requires states to run an electronic asset check (the Asset Verification Program under Section 1940 of the Social Security Act) when they determine or redetermine that eligibility. Because that resource check has to clear before the renewal can finish, these renewals are completed on a fully automatic basis less often than renewals for groups with no asset test.

The Renewal Packet and Your 30 Days

If the agency can't renew you automatically, it must send a renewal form filled in with the information it has, and give you at least 30 days from the date of the renewal form to respond, add anything missing, and sign it. The clock runs from the date on the form, not the day it reaches you. That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, your state may follow the same procedures but is not required to, so ask your state Medicaid agency what deadlines apply to you. Where it applies, 30 days is the federal floor; a state may allow longer, but never less.

Two protections travel with the packet. The agency may not require you to come in for an in-person interview as part of a renewal, and it must let you return the form by any of several methods, including mail, phone, online, or in person.

Return the packet on time. Missing the deadline can end coverage you were still entitled to keep, and it triggers a "procedural" closure, one based on paperwork rather than on a finding that you no longer qualify.

If Your Coverage Closes: The 90-Day Reconsideration Window

A procedural closure is not the end of the road. Under 42 CFR 435.916, when coverage is terminated because you didn't return the renewal form in time, the agency must reconsider your eligibility without making you file a new application if you submit that form within 90 days after the termination date. That duty is federal for MAGI-based coverage and a state option on the non-MAGI pathways above, so ask your state Medicaid agency.

The window guarantees reconsideration without a new application. It does not, on its own, guarantee that coverage is restored all the way back to the closure date with no gap. Whether reinstatement reaches back to the date your case closed is set by state policy, not by this federal rule. If you're inside the 90 days, send in the missing paperwork right away and ask the agency directly whether your coverage will be restored retroactively or only going forward.

When the State Can't Verify Your Citizenship or Assets

Sometimes the agency accepts that you qualify but can't immediately confirm one non-financial fact, most often citizenship or immigration status. Federal law does not let it cut you off while that resolves. Under 42 CFR 435.956(b), when you have declared U.S. citizenship, U.S. nationality, or a satisfactory immigration status and the agency can't promptly verify it, it must give you a reasonable opportunity period to produce documentation. The period ends on the earlier of two dates: the date the agency verifies your status or determines that you did not verify it, or 90 days after that notice. It can be extended past 90 days for someone declaring satisfactory immigration status who is making a good-faith effort to obtain documentation, and a state may not cap how many reasonable opportunity periods you receive.

The key protection: during the reasonable opportunity period, the agency may not delay, deny, reduce, or end benefits for someone it has otherwise found eligible.

Children, New Mothers, and Returned Mail

Two federal rules add protection on top of the ordinary renewal cycle. A third, returned mail, changed in 2026 and now offers much less.

Children keep coverage for a full year. Since January 1, 2024, every state must give children under age 19 twelve months of continuous eligibility in Medicaid and the Children's Health Insurance Program (CHIP). A child determined eligible stays eligible for the full 12 months even if the family's income rises during the year, until the child turns 19 or moves out of state. This requirement, added by the Consolidated Appropriations Act, 2023, means a mid-year income change generally will not knock a covered child off before the next renewal.

New mothers can keep coverage for 12 months after pregnancy. States have a permanent option to extend a woman's Medicaid or CHIP coverage for a full 12 months after her pregnancy ends, replacing the older 60-day postpartum window, with full benefits throughout. Confirm with your state Medicaid agency whether your state took it.

Returned mail is no longer covered by a federal search requirement. The federal rules that required an agency to search for a new address before acting on returned mail were removed from the Code of Federal Regulations effective July 31, 2026. Federal law now says only that an agency may act without advance notice when mail comes back with no forwarding address and your whereabouts are unknown, and that coverage must be reinstated if your whereabouts become known while you are still eligible. Your state may still have procedures of its own, so contact your state Medicaid agency if your mail was returned. Either way, the surest protection is to report an address change the moment you move.

Your Appeal Rights and Keeping Coverage During an Appeal

If the agency denies, reduces, or ends your Medicaid and you think it's wrong, you can challenge it. Section 1902(a)(3) of the Social Security Act and 42 CFR 431.220 guarantee every applicant and enrollee the right to a fair hearing before the state agency whenever a claim is denied, not acted on promptly, or subject to an adverse decision.

You have time to file, but probably less than you think. Under 42 CFR 431.221(d), a state must allow a reasonable time to request a hearing, and that time may not exceed 90 days from the date the notice of action is mailed. Read that as a ceiling on what a state may offer, not a floor you are guaranteed: a state may set a shorter window, and a shorter state deadline is enforceable against you. Georgia DFCS policy, for example, directs that a hearing on an eligibility decision be requested within 30 days of the notice. So the deadline that governs your appeal is the one printed on your own notice of action, which may be well short of 90 days.

There's a second clock that decides whether your coverage keeps flowing while you appeal. This is often called aid paid pending. Under 42 CFR 431.230, when the agency sends the required advance notice of a change (generally at least 10 days ahead) and you request a hearing before the change takes effect, the agency may not reduce or end your services until a decision is issued after the hearing. That protection has one carve-out: it does not apply when the sole issue on appeal is a question of federal or state law or policy rather than a fact about your case. Request the hearing after the effective date and continuation isn't automatic, though a separate rule lets the agency reinstate services if you ask within 10 days of the action. One caution: if the hearing decision goes against you, the state is allowed to recoup the cost of the benefits it continued only because you appealed.

What Changes in 2027

Two federal changes take effect for renewals and coverage dated on or after January 1, 2027. Both come from the 2025 budget-reconciliation law (Public Law 119-21).

A six-month cycle for expansion adults. Section 71107 amends the Social Security Act to require states to redetermine eligibility once every six months, rather than every 12 months, for the ACA Medicaid expansion adult group (and people otherwise enrolled under a waiver of the state plan that provides coverage equivalent to minimum essential coverage), for redeterminations scheduled on or after January 1, 2027. The statute grants exactly one exemption from the six-month cadence, and it is narrow: an Indian or Urban Indian as those terms are defined in the Indian Health Care Improvement Act, a California Indian, or a person otherwise determined eligible as an Indian for the Indian Health Service. The same law separately excuses a longer list of people from its new community-engagement (work) requirement, including someone who is medically frail or the parent or caretaker relative of a dependent child 13 and under. A work-requirement exemption is not a renewal exemption: an expansion adult who is medically frail still renews every six months. Enrollees outside the expansion adult group and that equivalent-coverage waiver group are not covered by this requirement and stay on the standard 12-month cycle.

A shorter retroactive-coverage window. Federal law currently requires states to cover care you received in the three months before the month you applied, if you would have qualified then. This "retroactive eligibility" is a look-back that pays old bills, not a waiting period before coverage starts. Section 71112 shortens that window for applications filed on or after January 1, 2027, to two months before the application month for most enrollees (and CHIP), and one month for the ACA expansion adult group. The path that covers a deceased person's care through an application filed on their behalf continues, under the same shortened windows.

How Medicaid Renewal Differs by State

The federal frame above is the floor. On top of it, each state sets the details that determine how renewal actually feels: which agency runs it, whether you renew through an online account or by mail, how the state handles the resource check for aged and disabled enrollees, whether it has taken the 12-month postpartum option, whether reinstatement after a procedural closure reaches back to the closure date, and how it routes you into a managed-care plan once you're renewed.

We publish a dedicated renewal guide for all 50 states and the District of Columbia. Start at the Medicaid by State hub for the full picture of how your state runs Medicaid, or go straight to your state's renewal walkthrough below.

Find Your State's Medicaid Renewal Guide

Select your state for its renewal agency, portal, deadlines, and the local details that sit on top of the federal rules described above.

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51 states

Frequently Asked Questions

How often do I have to renew my Medicaid?

Most enrollees are redetermined once every 12 months under 42 CFR 435.916, on a schedule tied to when you were last approved. Starting with renewals scheduled on or after January 1, 2027, the ACA expansion adult group moves to every six months.

Do I have to fill out a form every year?

Not always. The agency must first try to renew you automatically from data it already has, and if it can, it just sends a notice confirming the renewal and you don't have to return anything. You only get a form when the agency can't confirm your eligibility on its own, and then you have at least 30 days from the date on the form to return it (required for MAGI-based coverage; a state option otherwise).

My Medicaid closed because I missed the renewal deadline. Can I get it back without reapplying?

Often, yes. If the closure was for not returning the renewal form, submitting it within 90 days of the termination date requires the agency to reconsider your eligibility without a new application (required for MAGI-based coverage; a state option otherwise). Whether your coverage is restored back to the closure date, or only going forward, depends on your state's policy, so ask the agency directly.

Can I keep my coverage while I appeal a decision?

If you request a fair hearing before the change takes effect (the agency generally gives at least 10 days' advance notice), your benefits continue until a hearing decision is issued, unless the only thing in dispute is a question of federal or state law or policy rather than a fact about your case. If the decision goes against you, the state may recover the cost of the benefits it kept paying during the appeal.

What if I moved and my renewal mail was returned?

The federal rules that required an agency to search for a new address before acting on returned mail were removed from the Code of Federal Regulations effective July 31, 2026. Federal law now says only that an agency may act without advance notice when mail comes back with no forwarding address and your whereabouts are unknown, and that coverage must be reinstated if your whereabouts become known while you are still eligible. Your state may still have procedures of its own, so contact your state Medicaid agency. Report your new address as soon as you move to avoid the problem entirely.

Learn More

MedicaidHow to Appeal a Medicaid Denial: Your Fair Hearing RightsDenied Medicaid? You can appeal, and one deadline decides whether your benefits keep flowing during the appeal. Know your fair-hearing rights and act fast. MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidMedicaid Income Limits by State: Which Number Applies to YouMedicaid income limits depend on your pathway: expansion adults, aged and disabled, or nursing-home care. See the 2026 figures and your state's exact limits. MedicaidMedicaid by State: Eligibility, Coverage, and How to ApplyMedicaid works differently in every state, from who qualifies to what's covered and how to apply. See what varies and jump to your state's full guide. MedicaidWill Medicaid Take Your House? Medicaid Estate Recovery ExplainedMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting.

Find personalized help keeping your Medicaid coverage through renewal at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.