How to Switch My Medicaid Plan

To switch your Medicaid plan, you first need to check your eligibility to see if you qualify for the new plan you want. You can do this through your state’s Medicaid agency or online. Once you have determined that you are eligible, you can submit an application to the new plan. You will need to provide personal information, such as your name, address, and income, as well as information about your health and medical needs. You can submit your application online, by mail, or in person. After your application is processed, you will receive a new Medicaid card that you can use to access services under the new plan.

Understanding Medicaid

Medicaid is a health insurance program jointly funded by the federal and state governments that provides coverage to low-income individuals and families. State Medicaid programs cover varying services in different states. To qualify for Medicaid, applicants must meet specific eligibility requirements. These requirements may include income, age, disability, or family size.

Eligibility Requirements

  • Income: Applicants must have an income below a certain level to qualify for Medicaid. The income limit varies by state and family size.
  • Age: Medicaid is available to children, pregnant women, and adults in some states.
  • Disability: Medicaid is available to people with disabilities in all states.
  • Family Size: Medicaid is available to families with children in all states.

Qualified Plans

You can choose from various Medicaid plans that offer different benefits, providers, and costs. Managed care plans are the most common type of Medicaid plan. With a managed care plan, you will have a primary care provider who will coordinate your care and refer you to specialists when necessary. Other types of Medicaid plans include fee-for-service plans and health maintenance organizations (HMOs).

Switching Medicaid Plans

You can switch Medicaid plans during the annual open enrollment period, typically from November 1 to January 31. You can also switch plans if you move or experience a change in your income or family size. To switch plans, you must contact your state Medicaid office or visit the state Medicaid website.

Table: Medicaid Plan Types

Plan TypeBenefitsProvidersCosts
Managed Care Plan
  • Preventive care
  • Doctor visits
  • Hospital care
  • Prescription drugs
  • Mental health services
  • Primary care providers
  • Specialists
  • Hospitals
  • Pharmacies
  • Mental health providers
  • Monthly premium
  • Copays for doctor visits and prescriptions
  • Deductible for hospitalization
Fee-for-Service Plan
  • Preventive care
  • Doctor visits
  • Hospital care
  • Prescription drugs
  • Mental health services
  • Any doctor or hospital that accepts Medicaid
  • No monthly premium
  • Copays for doctor visits and prescriptions
  • Deductible for hospitalization
Health Maintenance Organization (HMO)
  • Preventive care
  • Doctor visits
  • Hospital care
  • Prescription drugs
  • Mental health services
  • Doctors and hospitals that are part of the HMO network
  • Monthly premium
  • Copays for doctor visits and prescriptions
  • No deductible for hospitalization

Comparing Plan Options and Benefits

To make an informed decision about switching your Medicaid plan, it’s essential to compare different plan options and benefits carefully. Here are some key factors to consider:

  • Provider Network: Review the network of healthcare providers covered by each plan. Ensure that your preferred doctors, specialists, and hospitals are included in the plan’s network.
  • Covered Services: Compare the range of medical services covered by different plans. Look for plans that offer comprehensive coverage, including preventive care, prescription drugs, mental health services, and dental and vision care.
  • Copayments and Deductibles: Consider the copayments and deductibles associated with each plan. Copayments are fixed amounts you pay for specific services, while deductibles are the amount you must pay out-of-pocket before your insurance coverage kicks in.
  • Member Reviews: Read reviews and feedback from current or former members of different plans. This can provide valuable insights into the quality of care, customer service, and overall satisfaction with the plan.
  • Additional Benefits: Some Medicaid plans may offer additional benefits or services, such as transportation assistance, health screenings, or wellness programs. Consider these extra benefits when comparing plans.
  • Cost: While Medicaid is generally affordable, there may be differences in premiums or enrollment fees among different plans. Compare the overall cost of each plan, including any additional fees or charges, to make an informed decision.

Enrolling in a New Plan

Switching your Medicaid plan can be a great way to get the care you need and save money. Here’s what you need to know about enrolling in a new plan:

  • Check your eligibility. Not everyone is eligible for Medicaid. You can check your eligibility by visiting the website or by contacting your state Medicaid office.
  • Choose a plan. There are many different Medicaid plans available. You can compare plans by visiting the website or by contacting your state Medicaid office.
  • Apply for coverage. Once you’ve chosen a plan, you can apply for coverage by visiting the website or by contacting your state Medicaid office.
  • Complete the enrollment process. Once your application is approved, you’ll need to complete the enrollment process. This may involve providing additional information or attending a meeting with a Medicaid representative.
  • Start receiving benefits. Once you’re enrolled in a Medicaid plan, you’ll start receiving benefits. These benefits may include doctor’s visits, hospital stays, prescription drugs, and more.
Medicaid Plan Comparison
PlanMonthly PremiumDeductibleCoinsuranceCopay
Aetna Better Health$0$50020%$15
Ambetter from Healthfirst$10$25010%$10
Centene Corporation$20$40020%$15
Humana Healthy Horizons$25$50025%$20

Why You Need to Switch Your Medicaid Plan

There are many reasons why you might need to switch your Medicaid plan. You might have moved to a new county or state, your income or family size might have changed, or you might simply be unhappy with your current plan. Whatever the reason, it’s important to know how to switch your plan so that you can get the coverage you need. Your Medicaid card will remain the same even when changing plans as long as you stay with the same state Medicaid program.

Things to Consider Before Switching Plans

  • Your needs: Consider your specific health care needs, including any ongoing or chronic conditions you have.
  • Provider network: Make sure your new plan has a network of providers that you can easily access.
  • Cost: Compare the costs of different plans, including premiums, deductibles, and copayments.
  • Benefits: Review the benefits offered by each plan to make sure they meet your needs.
  • Customer service: Read reviews and talk to other members to get a sense of the customer service provided by each plan.

How to Switch Your Medicaid Plan

There are two ways to switch your Medicaid plan: online or by mail.


  • Visit your state’s Medicaid website.
  • Find the section on changing plans.
  • Follow the instructions to select a new plan.

By Mail

  • Contact your state’s Medicaid office and request a change of plan form.
  • Fill out the form and return it to the Medicaid office.

Transitioning to Your New Plan

Once you have switched your Medicaid plan, you will need to take some steps to transition to your new plan.

  • Choose a primary care provider (PCP): If you don’t already have a PCP, you will need to choose one. Your PCP will be your main point of contact for your health care.
  • Get a new Medicaid card: You will receive a new Medicaid card from your new plan. Make sure to keep your new card with you at all times.
  • Update your information: Make sure your new plan has your correct contact information, including your address, phone number, and email address.
  • Contact your providers: Let your providers know that you have switched Medicaid plans. They will need to update their records and may need to send you new prescriptions.

What if I Have Questions?

If you have any questions about switching your Medicaid plan, you can contact your state’s Medicaid office or your new plan’s customer service department. You can also find helpful information online at the Medicaid website.

Additional Information

State Medicaid WebsitesMedicaid Customer Service Numbers
Medicaid.gov1-800-MEDICARE (1-800-633-4227)
Healthcare.gov1-800-318-2596 (TTY: 1-855-889-4325)

Thanks for sticking with me through this guide on changing your Medicaid plan. I know it can be a lot to take in, but I hope you found the information helpful. If you have any more questions, please don’t hesitate to reach out to your state Medicaid agency or a qualified healthcare professional. As always, we’ll be here to provide you with the latest tips, insights and information you need to navigate your Medicaid journey. So come back and visit us again soon!