I Have Lost My Medicaid Coverage. What Do I Do Now?

Q. What is Medicaid?
A. Medicaid is a government program that provides health coverage to qualified low-income individuals including families and children, pregnant women, the elderly, as well as people with disabilities. In some states, the program is available to all adults below a certain income level.

Q. What does Medicaid cover?
A. All Medicaid programs cover basic medical care, such as:

  • Inpatient hospital care
  • Doctors services
  • Outpatient hospital or clinic care
  • Lab and X-ray services
  • Short-term skilled nursing, rehab and home health care
  • Ambulance service
  • Pediatric care
  • Some Medicaid programs may also cover other medical care such as prescriptions, vision and dental care.

Q. How could I lose Medicaid?
A. Medicaid eligibility is based on many different requirements. Some reasons you could lose Medicaid coverage are:

  • You earn too much
  • You are no longer pregnant
  • You are no longer under a certain age
  • You inherit, win or are given assets that change your financial status
  • You fail to report a household change like getting married or adopting/having a child

Q. What are my healthcare options if I lose Medicaid?
A. If you lose Medicaid, your child or children may be eligible for the Children’s Health Insurance Program (CHIP). You can also buy your own coverage through our health plans or the Health Insurance Marketplace during the special enrollment period . Most special enrollment periods last 60 days from the date you lose coverage.

Q. Why should I shop through BCBSTX or on the Health Insurance Marketplace?
A. By using our site or the Health Insurance Marketplace , you’ll be able to shop for, compare and buy health insurance that fits your medical care needs and budget. You can also see if you qualify for low monthly premiums based on your family’s total income.

Q. What happens if I don’t enroll in health coverage after I’ve lost Medicaid?
A. If you aren’t insured, you may have to pay the fee that some uninsured people pay, which is applied to your tax return that you’ll file in 2015. However, if you don’t have coverage for less than 3 months of the calendar year, you don’t have to pay the fee.

  • Will be turning 18 next month and the Medicaid says I do not apply for coverage. I live withy mom and we just barely came in to low-income housing from being homeless for the past 8 months. This is all because the Trump administration changed the way Medicaid works and I am still trying to look for a job to pay some kind of health insurance. I do not think this is right for them to do this to us leading back down a spiral of tension to even got to a dentist appointment or when my mom had to get surgery for a tumor. They are making it even more of a struggle to just have the will to live in this country why take away one of the last resorts we have if we get seriously injured or need urgent medical attention. Makes me worried and I feel very lost as what I should do if anything happens down the road. I cannot cover all of those expenses during this time frankly or even for days or months to come. I'm not trying to complain here it is just that this impacts my will to see any good coming out of my future especially when I don't have an education yet and my highest level of completion it sophomore year. These next coming months or even years will be very hard day to day struggle if I can't even pay to get my cavities removed. I hope you can understand the side me and other people come from when you live in poverty and it is not your fault because this has happened to adults and especially teens.
  • In reply to Robbie:

    Hi Robbie. I understand your concern about not having coverage. I would recommend reaching out to the Health Insurance Marketplace to see if you will qualify for a subsidy to help reduce the cost of a plan. The Marketplace can be reached at (800) 318-2596. - Renee
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