HealthSherpa Blog

How to report a change in income or household size to Medicaid

Written by HealthSherpa | Jul 8, 2020 4:33:17 PM

Are you or your family enrolled in Medicaid or the Children’s Health Insurance Program (CHIP)? If you have any changes to your income or household, you’ll want to report these right away. Why? Because the amount you earn can impact the amount you pay for your health insurance through Medicaid. Likewise, fewer or more people in your household but your income remains the same? Then your financial obligation for your Medicaid plan may change too. Both of these things are why you should always report a change in income to Medicaid. And make sure to do it quickly—some states require that you report these changes within 10 days.

And how do you report a change in income to Medicaid? You'll need to contact your state's Medicaid office. Below is a step-by-step guide of what you'll need to report and how to report it.

Changes to your income

When you apply for Medicaid, you’ll need to disclose and document your household income. But of course, the unexpected can always happen. And if your income changes significantly, either increasing or decreasing, you will need to report it. 

Because Medicaid eligibility is determined based on MAGI (modified adjusted gross income), there are some kinds of income changes you won’t need to report. These include inheritance, child support received, a teenage child who has a job earning less than $6,300, or any kinds of educational scholarships for tuition and fees. 

Changes in household size

Your household size relative to your income can also impact your Medicaid eligibility and what you may need to contribute financially to your Medicaid coverage. So when your household size becomes larger or smaller than you originally said in your application, you will need to report that change. 

Some common changes in household size are those that are the result of marriage, death, birth, divorce, adoption, or placement of a child into foster care. Keep in mind that the Marketplace counts foster children as part of your household size. However, the income you receive as compensation for their care is not counted. 

How to report a change

To report a change, contact your state's Medicaid office. They'll tell you what documents they require, and they'll let you know if this changes your eligibility.

You can also report the change to the federal government through HealthCare.gov or HealthSherpa to see if you're eligible for other coverage. If you enrolled in Medicaid through HealthSherpa, you can log in to your account to report the change. If you enrolled in Medicaid through HealthCare.gov or another site, you can create an account with HealthSherpa and still report the change here. (You can also report the change directly through HealthCare.gov or wherever you originally enrolled.) Keep in mind that reporting to HealthCare.gov does not replace reporting the change to your state Medicaid office.

If I’m no longer eligible for Medicaid, what are my other insurance options?

You have several other coverage options.

  1. Marketplace/Obamacare plan. You can enroll in a Marketplace health insurance plan, also known as Obamacare or Affordable Care Act insurance. See plans and prices here.
  2. Medicaid. You also may be eligible for Medicaid, depending on your income. You can see if you’re eligible and apply here.
  3. COBRA. If you’ve been laid off recently, you usually have the option of COBRA, where you pay the full premium of the same insurance your employer purchased for you. COBRA is typically much more expensive than Marketplace insurance, but it allows you to continue the coverage you already had. Learn more about comparing COBRA with Obamacare health insurance.

Medicare. Once you turn 65, you’re eligible for Medicare. Call us to enroll at (855) 677-3060.