Loss of Medicaid Coverage

Q. What is Medicaid?
A. Medicaid is a government program that provides health coverage to qualified low-income individuals. This includes pregnant women, families and children, the elderly and 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' visit
  • Outpatient hospital/clinic care
  • X-ray and lab services
  • Short-term skilled nursing, rehab and home health care
  • Ambulance service
  • Pediatric care

Some Medicaid programs might cover other medical care such as prescriptions, vision and even dental care.

Q. Why did I lose my Medicaid coverage?
A. Medicaid eligibility is based on a variety of factors. Some reasons you could lose Medicaid coverage are:

  • You earn too much money
  • You are older than the qualifying age
  • You inherit, win or are given assets that change your financial status
  • You failed to report a change in your household, such as getting married, adopting or having a child
  • You are no longer pregnant

Q. What are my health care 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). Your other option is to buy your own coverage. Choose one of our health plans or find one on the Health Insurance Marketplace leaving site icon during the special enrollment period. Most special enrollment periods last 60 days from the date you lose coverage, so don't wait!

Q. Why should I shop through BCBSIL or on the Health Insurance Marketplace?
A. You can do it all online! By using our site or the Health Insurance Marketplaceleaving site icon it's easy to shop. You can compare and buy health insurance that fits your medical needs and budget. You can also see if you qualify for low monthly premiums based on your family’s total income.

Need more information? Read about these topics.

Originally published 10/2/2014; Revised 2018, 2022, 2023, 2024

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