Keep your Medicaid during cancer treatment
Medicaid has a new rule about work. Many people with cancer do not have to meet it. But you may need to send papers to show that. This guide shows you how.
What is changing
Starting in 2027, or sooner in some states, many adults with Medicaid must work or do other activities for 80 hours a month. This is called a "work requirement" or "community engagement."
The rule is for adults age 19 to 64. It does not apply if you have Medicare.
Medicaid will also check if you still qualify every 6 months, not once a year.
If cancer makes it hard to work
The work rule may not apply to you. Medicaid calls this being "medically frail." It means your health makes it hard for you to work. It does not mean you are weak.
Having cancer is not enough on its own. Medicaid needs to see that your cancer or treatment makes it hard to work 80 hours a month. Your care team can help you show this.
Other people can also skip the rule. For example: parents of a child age 13 or younger, people who are pregnant, and some veterans. Take the short quiz to see what may fit you.
Five things to do now
- Open every letter from Medicaid. Read it the day it comes, or bring it to your care team. Fill out and send back every renewal form by its due date, even if you think the work rule does not apply to you.
- Keep your address and phone number up to date. If Medicaid cannot reach you, you could lose your coverage.
- Ask your cancer doctor for a letter. The letter should say how your cancer and treatment make it hard to work. Ask for a copy.
- Talk to a social worker or patient navigator. They can help you fill out forms and send papers.
- Keep copies of everything. Write down the date you sent each paper, and who you talked to.
If Medicaid says you did not meet the rule
You have 30 days to answer. Your coverage stays on while you answer.
- Call your care team right away. Bring or send them the letter.
- Send Medicaid what it asks for. This can be your doctor's letter or proof of work, school or volunteer hours.
- Call Medicaid a few days later. Ask if they got your papers.
If Medicaid still ends your coverage, you can ask for a "fair hearing." This means someone new looks at your case. Ask before the date your coverage ends, so it can stay on while you wait. Free legal help is available at LawHelp.org.
You can also apply for Medicaid again at any time. There is no waiting period.
If you lose Medicaid for this reason, you usually cannot get help paying for a Marketplace plan. Ask your hospital about financial help, and ask your care team about other programs.
Questions to ask your care team
- Can you write a letter that says how my treatment affects my ability to work?
- Who on my care team can help me with Medicaid papers?
- How long will my treatment last?
- When is my next Medicaid renewal?
- What should I do if I get a letter from Medicaid?
My Medicaid plan
Print this page and fill it in. Keep it with your Medicaid letters.
More help
- Take the short quiz to see which paths may fit you.
- Find your state's Medicaid office.
- Find free legal help in your state.
- Patient Advocate Foundation and Triage Cancer give free help to people with cancer.
This guide gives general information, not legal advice. Rules are different in each state and may change.