Healthcare

Changing from Marketplace to Medicaid or CHIP

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If you have Marketplace coverage and become eligible for Medicaid or the Children’s Health Insurance Program (CHIP) that counts as qualifying health coverage, consider ending your Marketplace coverage.

What counts as qualifying health coverage?

Once you're eligible for Medicaid or CHIP, you no longer qualify for savings on your Marketplace plan premiums or out-of-pocket costs. You'll have to pay full price for your Marketplace plan. 

1. Make sure you're eligible for Medicaid or CHIP

Your state may send you a letter that says you "may be eligible" or that "you're eligible but they may need more information." If they ask for information, send it right away. 

Wait until you have a final decision from your state agency that says you're eligible before you end your Marketplace coverage.

If you end your Marketplace plan before you get a final decision, you may have to wait to re-enroll and have a gap in coverage.

If you're not sure if you or household members have Medicaid, contact your state agency. For CHIP, call 1-877-KIDS-NOW (1-877-543-7669).

2. End Marketplace coverage

End your Marketplace coverage when your Medicaid or CHIP coverage starts. Your premium tax credit or extra savings won't stop automatically. 

Avoid paying back the premium tax credit
If you don't end your Marketplace coverage when Medicaid or CHIP coverage starts, you may have to pay back some or all of the premium tax credit you use when you file your federal taxes.

What if I want to keep both Marketplace and Medicaid or CHIP?

What if I get limited-benefit Medicaid coverage?

Get steps to end coverage


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