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HomeMemberManage Your PlanMedicaid Managed CareChanges to Medicaid Coverage

Here for Your Health logo

Important Changes Coming to Medicaid

Because of federal changes, some Medicaid members between ages 19–64 will have new requirements to keep their health coverage starting January 1, 2027.

Fidelis Care is here to help you understand the new Medicaid rules. Start getting ready now so you can keep your coverage. 

The two big changes you need to know

Number 1

Work requirements: Starting January 1, 2027, some Medicaid members will need to complete 80 hours each month of work, school, or helping in the community. If you are sick, pregnant, or caring for young children, you may not need to do this.


Number 2

Renew every six months: Some members will need to verify their Medicaid coverage two times a year instead of once. If you are affected by this change, you will need to report your household income every six months to see if you still qualify.

These changes start for affected members whose new coverage begins March 1, 2027. Going forward from March 1, members will be notified if they have to fulfill the work requirements before their new coverage begins.

Take Steps Now

Make sure NY State of Health has your correct phone number, email address, and home address.

Log in to NY State of Health

If you enrolled in Medicaid with your county's Local Department of Social Services, contact that office to update your information.

What are the work requirements?

Work requirements will go into effect for members whose new coverage starts on March 1, 2027. Members who need to complete these requirements will be notified before their renewal date. You will have to show you have done the work requirements for one month before your renewal and continue to meet them each month afterward.


You can fulfill the requirements through one of the below methods or a combination of those activities.

YOUR HOUSEHOLD INCOME

Earn at least

$580

per month

Seasonal income is averaged across the year.

WORK, SCHOOL, OR SERVICE TIME

Complete at least

80 hours

per month

Work, school, job training, and volunteering all count.

Will the work requirements apply to you?

The work requirements rule is for some adults who have Medicaid coverage. Many people will not be affected, including people who are:

  • 18 years old or younger
  • 65 years old or older
  • Pregnant, or were pregnant in the last 12 months
  • Enrolled in Medicaid with a disability
  • Diagnosed with a physical or mental health condition that makes it hard to work
  • Entitled to, or enrolled in Medicare Part A or enrolled in Part B
  • American Indian or Alaska Native
  • A parent, guardian, or caregiver to a disabled individual
  • A parent, guardian, or caretaker to a child under 14
  • In a SNAP household, and subject to SNAP work requirements
  • Enrolled in TANF and meeting TANF work requirements
  • In a program to help with drug or alcohol use
  • Currently in jail or prison, or released in the last 90 days
  • Currently in foster care
  • Formerly in foster care, discharged between the ages of 18-21, and currently under age 26
  • A veteran with a total disability

By September 15, 2026, NY State of Health will send you a text, mail, or email (if you chose electronic notices) if you need to complete the new requirements. The notice will tell you what actions you will need to take to stay covered. If you do not get a notice, the requirements may not apply to you.

What does the new renewal process look like for you?

NY State of Health will have you go through the renewal process every six months to make sure you still qualify for Medicaid coverage. You will be asked to provide your household income and other information. This process will be similar to what you do now. The biggest difference is you will need to do it every six months instead of every 12 months. This change will go into effect for members whose new coverage starts on March 1, 2027.


Fidelis Care is here for your health – every step of the way

We understand this is a big change and may be confusing. We are here for you and will continue to share updates on this page as more information becomes available. Start thinking now about a plan to meet the requirements. It's also important that you stay connected with both Fidelis Care and NY State of Health to ensure you stay covered.

Stay connected with Fidelis Care
Stay connected with NY State of Health