US Healthcare · System Basics
Medicaid When You Move or Your Income Changes
What happens to your Medicaid when you relocate to another state or your household income goes up or down — including reporting requirements, continuity of care rules, and how to avoid a coverage gap.
Medicaid enrollees who are planning to move to a different state, have recently moved, or have experienced a job change, raise, job loss, or other shift in household income.
Medicaid is a state-administered program, which means your coverage is specific to the state you live in. When your situation changes — you move, your income rises or falls, or your household composition shifts — your Medicaid eligibility can change too. Understanding what to report, when to report it, and what to expect next helps you avoid unexpected coverage gaps. For background on how Medicaid works overall, see the Medicaid and CHIP guide.
Moving to a different state
Medicaid does not follow you when you cross state lines. Each state runs its own program with its own eligibility rules, income limits, and covered services. If you are enrolled in Medicaid in State A and you move to State B, your coverage in State A will end and you must apply in State B from scratch.
Steps when moving states
- Apply in your new state as soon as possible after establishing residency — do not wait until your old coverage ends to start the application.
- Notify your current state that you have moved. Continuing to receive benefits in a state where you no longer reside can create an overpayment issue.
- Gather proof of residency for the new state — a lease, utility bill, or official mail addressed to your new address.
- Resubmit all eligibility documentation — income, household size, citizenship or immigration status — because the new state conducts an independent determination.
- Check whether the new state has expanded Medicaid under the ACA. If you moved from a non-expansion state to an expansion state (or vice versa), you may gain or lose eligibility based on income alone.
- Ask about a transition period for ongoing care — some states have continuity of care requirements that allow you to continue seeing a current provider for 90 days or longer while you establish care with a new network provider.
What to expect regarding a coverage gap
There is no federal rule that eliminates coverage gaps when you move between states. You will have a gap until the new state approves your application. Some applicants are able to minimize the gap by applying before they physically arrive in the new state, provided they can document that the move is imminent. Ask the new state Medicaid agency whether they accept applications before residency is fully established.
When your income changes
Medicaid eligibility for most adults is based on MAGI — Modified Adjusted Gross Income — calculated at the household level. Income changes that push your household above or below the eligibility threshold can affect your coverage.
| Type of change | Likely effect |
|---|---|
| Income increase above Medicaid limit | Medicaid ends; you can enroll in a Marketplace plan within 60 days |
| Income decrease to Medicaid-eligible range | You may become newly eligible; apply or report the change |
| Job loss | Income drop may make you newly eligible for Medicaid; job loss is also a qualifying event for Marketplace special enrollment |
| New household member (birth, marriage) | Household size increases, which may lower income-to-poverty ratio and improve eligibility |
| Household member leaves | Household size decreases, which may raise income-to-poverty ratio and reduce eligibility |
Reporting requirements: the 30-day rule
Most states require Medicaid enrollees to report changes in income, household size, or other eligibility factors within 30 days of when the change occurs. Some states have different windows, and some changes — such as a new address — may need to be reported even sooner.
Documents and terms you’ll see when reporting a change
- Notice of action — the official letter from your state Medicaid agency explaining a change in your benefits or eligibility. See notice of action in the glossary.
- Annual redetermination — the renewal process the state initiates once a year to confirm you still qualify. See redetermination in the glossary.
- Special enrollment period (SEP) — a 60-day window that opens when you lose Medicaid, allowing you to enroll in a Marketplace plan outside of open enrollment. See special enrollment period in the glossary.
To report a change, contact your state Medicaid agency by phone, through the online portal, or in person. If you applied through healthcare.gov, you can also log in and update your application there.
If your income rises above the Medicaid limit
When your income increases beyond the Medicaid eligibility threshold, the state will initiate a termination of your coverage and send a notice of action. This notice is important — it will include the last date of coverage and information about your appeal rights.
Losing Medicaid coverage is a qualifying event that opens a special enrollment period (SEP) on the Marketplace. You have 60 days from the date your Medicaid ends to enroll in a Marketplace plan. Depending on your income, you may be eligible for a premium tax credit that reduces your monthly premium.
If you believe the termination is incorrect — for example, the state used outdated income information — you can appeal within the timeframe stated on the notice.
If your income drops and you may now qualify
If you lose a job, see hours cut, or otherwise experience a significant income reduction, you may newly qualify for Medicaid. The best way to find out is to report the income change to your state Medicaid agency or to update your application on healthcare.gov.
If you currently have a Marketplace plan and you become eligible for Medicaid, your Marketplace plan and any premium tax credits will end — you cannot receive both simultaneously. However, Medicaid may provide more comprehensive coverage at lower or no cost to you.
Protections for children: continuous eligibility
Many states have adopted 12-month continuous eligibility for children enrolled in Medicaid or CHIP. Under this policy, once a child is determined eligible, coverage continues for the full 12-month eligibility period regardless of changes in family income during that time. Coverage only gets re-evaluated at the annual renewal.
This protection does not apply to adults in most states. Check with your state Medicaid agency to understand whether and how continuous eligibility applies to your children’s coverage.
Planning ahead to avoid a coverage gap
The most effective way to avoid a coverage gap is to act quickly — apply in the new state before your old coverage lapses, report income changes promptly so the state can adjust benefits rather than terminate them retroactively, and respond to renewal and redetermination notices on time. If your income is close to the threshold, tracking it monthly can help you anticipate a change before it triggers a notice.
Key terms
| Term | Plain meaning | Glossary |
|---|---|---|
| MAGI | Modified Adjusted Gross Income — the income measure used to determine eligibility for most Medicaid categories | → |
| Continuous eligibility | A policy some states use to keep children enrolled in Medicaid or CHIP for a full 12 months regardless of income changes during that period | → |
| Qualifying event | A change in life circumstances that triggers a special enrollment window for Marketplace plans | → |
| Medicaid expansion | The ACA option allowing states to extend Medicaid to adults below 138 percent of the federal poverty level | → |
| Disenrollment | The process by which a person loses Medicaid coverage, either due to income changes, failure to renew, or a move | → |
Common questions
- Can I keep my Medicaid when I move to a different state?
- No. Medicaid is administered by each state, and coverage does not transfer across state lines. You must apply for Medicaid in your new state. Your old coverage will end, and you will need to meet the new state's eligibility rules.
- Is there a gap in coverage when I move states?
- There can be. Your old state coverage typically ends when you establish residency in a new state. You should apply in the new state as soon as possible after moving. Some new states may require proof of residency before approving coverage.
- How quickly do I need to report a change in income?
- Most states require you to report income changes within 30 days of when the change occurs. Check your state's specific rules, as the timeframe can vary. Failure to report can result in overpayments that the state may seek to recover.
- What if my income goes up and I no longer qualify for Medicaid?
- You will be disenrolled from Medicaid. Losing Medicaid coverage is a qualifying event that opens a special enrollment period on the Marketplace, so you can enroll in a Marketplace plan within 60 days without waiting for open enrollment.
- What if my income drops and I might now qualify for Medicaid?
- If your income drops, you may become newly eligible for Medicaid. Report the change to your Marketplace or state agency; if you're found eligible for Medicaid, your Marketplace plan subsidy will end, but you'll gain Medicaid coverage.
- Do children have more protection from losing coverage due to income changes?
- Yes. Many states have adopted 12-month continuous eligibility for children enrolled in Medicaid or CHIP, meaning an income increase mid-year will not trigger disenrollment until the next renewal period.
- What happens to my prescriptions and ongoing care when I move states?
- Your new state's Medicaid plan may have a different formulary and provider network. Ask your new plan about continuity of care rules, which may allow you to stay with an existing provider for a transition period, especially for ongoing treatment.
Sources
Last reviewed: September 2026