Understanding Medicaid eligibility

Where can I find Medicaid coverage updates?

At the beginning of the COVID-19 pandemic, Medicaid agencies paused eligibility reviews so those with benefits could keep them. This review could affect your Medicaid eligibility. You can learn more about your state’s eligibility requirements on the Medicaid website.

What is Medicaid redetermination?

This is the process that states use to ensure that Medicaid enrollees continue to be eligible for Medicaid coverage. This is also called "renewal", "­redetermination" or "­recertification" review.

Here’s how it works: Your state will send you a renewal letter 45 to 30 days before your renewal date to recertify your Medicaid eligibility.

• If you complete your recertification and still qualify, you don't need to do anything else. You’ll remain a Medicaid enrollee.
• If you don’t complete your recertification by the renewal date, you will be disenrolled from Medicaid. You will need to reapply.
• If you complete your recertification and don’t qualify, you will be disenrolled from Medicaid. You can apply for a Banner|Aetna individual & family health plan.

Other health coverage is available to you

What‘s the difference between Medicaid and ACA coverage?

Both Medicaid and ACA coverage provide health insurance to millions of Americans. However, these two types of coverage are often confused. We’ll explain some of the differences here.

Medicaid 

Medicaid is a government program. It provides health insurance to eligible low-income adults, children, pregnant women and people with disabilities. The coverage is based on financial need. Medicaid is different in each state. That means your eligibility depends on where you live.

ACA plans 

Affordable Care Act (ACA) plans are offered through the Health Insurance Marketplace® and private health insurance companies, like us. Anyone who is a U.S. citizen, national or lawfully present, can get ACA coverage, no matter your income. And you can’t be denied coverage, or charged more for coverage, for a previous health problem. For more eligibility information, check out this quick guide to the Health Insurance Marketplace

ACA plans are a great option for you if:

• You don’t qualify for Medicaid coverage 
• You recently lost your Medicaid coverage
• You don’t have health coverage through your job

ACA plans cost more than Medicaid. The great news is financial help is available to make your ACA plan more affordable. In fact, you may be able to qualify for a $0* or low plan premium. check out this quick guide to the Health Insurance Marketplace What do Affordable Care Act (ACA) plans cover? Every ACA health plan covers a minimum of 10 essential benefits. This includes prescription drugs, maternity and newborn care, mental health and more. 

What do Affordable Care Act (ACA) plans cover?

Every ACA health plan covers a minimum of 10 essential benefits. This includes prescription drugs, maternity and newborn care, mental health and more. 

Find the full list of covered essential benefits.

You can shop for a health plan today

How can I explore Banner|Aetna individual & family plans?

Open Enrollment starts November 1.  It’s the perfect time to explore your plan options so you’re covered in 2024. To get started, enter your ZIP code below.

Start here to find an affordable plan

How do I know which plan is right for my budget?

Every ACA plan is assigned a metal tier: Platinum, Gold, Silver or Bronze. All plans offer the same quality of care. The metal tier is based on how you and your plan split the costs. Understanding plan levels and costs can help you pick the right plan for you.

Will I qualify for a subsidy?

When you apply for an Affordable Care Act (ACA) plan, you may qualify for a premium tax credit (sometimes called a subsidy). This can lower your monthly premium or even give you a $0 monthly premium.* Other assistance may also be available. You can visit the Health Insurance Marketplace^® to check if you might be eligible for a lower monthly premium before you shop.