Millions of people who rely on Medicaid could lose eligibility & be without coverage.
Coverage Update
Millions Who Rely on Medicaid Could Lose Coverage — What to Do Next
Updated Oct 15 • Written by Robert Adams
Fast take: Millions of Americans are projected to lose Medicaid coverage as federal funding and eligibility provisions unwind. If this impacts you, act quickly—many qualify for a Special Enrollment Period to transition into new coverage and avoid a lapse.
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Get Free Quotes Book a CallWhat’s Happening
During the pandemic, Medicaid programs expanded eligibility and paused re-verification to keep people covered. Those emergency measures are now ending. States are re-checking eligibility, and many Americans are finding their Medicaid coverage is being terminated—even if their income hasn’t changed drastically.
At RKA Insurance Advisors, we understand the confusion this creates. We help individuals and families review options fast to avoid any coverage gaps—whether through the Marketplace or an underwritten private PPO plan that offers nationwide access and flexibility.
What You Can Do Right Now
Once you lose Medicaid, you trigger a 60-day Special Enrollment Period (SEP). This is your limited window to enroll in a new plan and keep continuous coverage.
- Marketplace (ACA) Plans: You may qualify for premium tax credits or cost-sharing reductions based on income.
- Private PPO Plans: Medically underwritten plans may provide broader networks and lower deductibles for qualified applicants.
- COBRA: If you recently left an employer plan, COBRA continuation may still be available as a bridge option.
When Coverage Starts
- Enroll by the 15th: Coverage typically starts the 1st of the next month.
- Enroll after the 15th: Coverage usually starts the 1st of the following month.
- Bring Documentation: Keep your Medicaid termination letter—it’s required proof for a Marketplace SEP.
How to Protect Your Wallet
- Start your SEP immediately. Waiting even a few weeks can delay your effective date and leave you uninsured.
- Compare your total annual cost. Don’t just look at the premium—factor in deductibles, copays, and max out-of-pocket.
- Check providers and prescriptions first. Confirm your doctors and medications are in-network before you switch.
- Consider PPO flexibility. If you travel or need out-of-state care, Private PPOs often provide better nationwide access.
Not Sure Which Option Fits Your Family?
We’ll compare ACA vs. Private PPOs with your doctors and medications in mind and show clear, side-by-side costs—so you can decide confidently.
Get Free Quotes Book a CallQuick FAQs
Will I be uninsured right away if I lose Medicaid?
No. If you act quickly, you can transition directly into Marketplace or Private PPO coverage without a lapse.
Can I get premium help?
Yes. Marketplace plans often include tax credits that lower your monthly premium based on income.
What documents do I need?
Keep your Medicaid termination or eligibility notice. It’s required to confirm your Special Enrollment eligibility.
Can I switch plans later?
After your SEP ends, you typically need to wait for Open Enrollment or another qualifying life event to change coverage.
Robert Adams • President & Licensed Agent • NPN 19540130
Licensed in AL, CO, DE, FL, GA, IA, IL, IN, KY, KS, LA, MD, MI, MO, MS, MT, NC, NE, NV, OH, OK, SC, SD, TN, TX, UT, VA, WI, WV, WY
For education only; availability and benefits vary by carrier and state.
