Documents to confirm you don’t have qualifying health coverage through Medicaid or the Children’s Health Insurance Program (CHIP)

Submit one of the documents below if you need to confirm that you don’t have coverage through Medicaid or CHIP.

Note: Some Medicaid and CHIP programs are known by names specific to that state. Find the name of Medicaid & CHIP programs in your state.

  • Letter or statement from a Medicaid or CHIP agency that shows that you or your family members aren’t enrolled in or eligible for Medicaid or CHIP
  • Letter or statement from a Medicaid agency showing that you or a family member are enrolled in a Medicaid program that’s not considered qualifying health coverage

       - Medicaid coverage only for pregnancy-related services
       - Medicaid coverage only for family planning services
       - Medicaid coverage only for tuberculosis coverage
       - Medicaid coverage only for emergency treatment
       - Medicaid Demonstration Projects that cover a limited range of benefits
       - Medicaid coverage for “medically needy” individuals whose income is too high             for traditional Medicaid and cover a limited range of benefits. These programs              are sometimes known as “Share of Cost” or “Spend Down” programs.

  • A letter describing your recent health coverage including:

      - The name of the Medicaid/CHIP program you were enrolled in and when your              coverage ended, or
      - That you were never enrolled in Medicaid/CHIP coverage, or
      - The name of the Medicaid/CHIP program with limited benefits that you’re                      enrolled in that would still allow you to enroll in the Marketplace with help paying          for coverage

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