New Rules for Medicaid Coming Soon

A new federal law adds new rules for up to 320,000 Maryland Medicaid members. The Maryland Department of Health, Maryland Health Connection, and local partners are here to help you stay covered.

Quick Links:

Did you get a notice?
What is changing?
What is changing for immigrants?
Do these rules apply to you?
Who does not have to meet work rules?
When does this start?
How do you report your work?
What should you do now?

Did you get a notice from Maryland Health Connection?

You received a letter or email because the new Medicaid work rules may apply to you.

Log in to your Maryland Health Connection account or use our quick online tool to see if you need to follow these rules.

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What is changing?

Starting Jan. 1, 2027, the federal government is adding new rules for some adults to keep Medicaid. You will need to:

1. Show that you work or do other approved activities.

2. Renew your Medicaid coverage two times a year (every 6 months) instead of once a year.

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What is changing for immigrants?

As of Oct. 1, 2026, some immigrants no longer qualify for Medicaid.

• This rule applies only to adults.

• Children and pregnant people will not lose coverage under this rule.

You qualify for Medicaid if you are one of these categories:

• Cuban/Haitian entrant

• Compact of Free Association (COFA) migrant

• Lawful Permanent Resident

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Do these rules apply to you?

Use our online tool

Log in to your account, use our online tool, or ask Flora (our virtual assistant) to see if these rules apply to you.

These changes apply to adults who:

• Are 19 to 64 years old

• Earn up to $21,000 a year for one person, or up to $44,000 a year for a family of four

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Who does not need to meet work rules?

You do not have to meet work rules if any of the following apply to you:

General Exceptions

• You are under 19 years old

• You are 65 or older

• You have Medicare (Part A or Part B)

• You were in jail or prison in the past 90 days

Special Exceptions

• You are under 26 and were in foster care

• You are American Indian or Alaska Native

• You care for a child under age 14

• You care for a person with a disability

• You are a veteran with a disability

• You are pregnant or gave birth in the past 12 months

• You get TANF benefits and follow its work rules

• You are subject to SNAP (food stamps) work rules

• You are currently in jail or prison

Health Conditions

You do not have to meet work rules if you have a health condition that limits your work, such as:

• Blindness or a physical disability

• Mental health condition

• Substance use disorder or being in a treatment program

• Complex medical condition

Short-Term Hardship Exceptions

You do not need to meet work rules if, since your last renewal:

• You stayed overnight in a hospital, nursing home, or care center

• You traveled outside your area to get medical care for yourself or a family member

Special Local Exceptions

You may not need to meet work rules if you live in an area with high unemployment or a declared emergency. We will send you a letter if this applies to you.

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When does this start?

The new rules start in Jan. 2027.

When you renew your Medicaid in 2027, you must show that you met the work requirement for at least one month.

Maryland Health Connection sent notices in Sept. 2026 to members who need to meet these rules.

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How do you report your work?

Starting Jan. 1, 2027, Maryland Health Connection will check if you meet the work rules using data we already have.

If we need more proof, we will send you a letter or email. The notice will explain what information to send us and how to send it so you do not lose coverage.

If you must meet work rules, you can do any of these each month:

• Earn at least $580 a month from a job

• Go to school at least half-time

• Complete 80 hours a month of any mix of these activities:

  • Paid work

  • School

  • Job training

  • Volunteering

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What should you do now?

1. Check if these rules apply to you. Log in to your account or use the online tool.

2. Keep your contact information updated in your account.

3. Report changes to your income or family size.

4. Read all letters and emails from Maryland Health Connection.

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