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    Medicaid ENGAGE

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    Division of Medicaid & Medical Assistance

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    Medicaid ENGAGE

    Medicaid changes are coming!

    Do these things now to get ready for new federal Medicaid changes…

    • Create a My ASSIST account.
    • Download the FREE MyDEMedicalAssistance mobile app – find it on the Apple App or Google Play store.
    • Make sure we have your current address and phone number.
    • Read all mail from the Department of Health and Social Services (DHSS).
    • Sign up for emails and text messages.

    IMPORTANT NEWS!
    If you are not a U.S. citizen, your Medicaid coverage could soon end because of a new federal law.
    You must let your Medicaid case manager know if your immigration status has changed.

    Starting October 1, 2026, non-citizens must have one of these immigration statuses to receive full Medicaid benefits:

    • Lawful Permanent Resident with a Green Card who:
          • Have completed the five-year waiting period, or
          • Have an immigration status that did not require the five-year waiting period
    • Cuban or Haitian entrant;
    • COFA migrant (citizen of the Marshall Islands, Micronesia, or Palau living in the United States under the Compact of Free Association, or COFA);

    Pregnant women and children may qualify for full Medicaid even if your immigration status is not on the above list. This is because pregnant women and children have different rules under Delaware’s elected CHIPRA 214 option.

    At the end of those four months, if you do not have one of the immigration statuses listed above, your full Medicaid coverage will end. However, you may still be eligible for labor and delivery services and emergency medical services. IMPORTANT: You can ONLY receive these services in a hospital emergency room, acute care inpatient hospital or a birthing center, AND, they are limited to care for:

    • Labor and Delivery
    • A Sudden serious medical situation that is life threatening, or a severe acute illness or accidental injury that demands immediate medical or surgical attention, and
    • Without lifesaving treatment, you could suffer serious long-lasting disability.
    • Individual granted asylum under §208 of the Immigration and Nationality Act (INA);
    • Refugee who is admitted to the United States under §207 of the INA;
    • Individual paroled into the United States;
    • Individual paroled into the United States under §212(d)(5) of the INA for a period of at least 1 year;
    • Alien whose deportation is being withheld under §243(h) of the INA or §241(b)(3) of the INA;
    • Alien granted conditional entry pursuant to §203(a)(7) of the INA as in effect before April 1, 1980;
    • Individual who has been battered or subject to extreme cruelty and has a pending or approved petition under the Violence Against Women Act (VAWA);
    • Victim of human trafficking and certain family members under the Victims of Trafficking and Violence Protection Act of 2000;
    • Amerasian immigrant under §204(f) of the INA;
    • Noncitizen honorably discharged veteran, active duty member of the U.S. Armed Forces and their spouse or unmarried dependent children;
    • Certain Afghan parolees under Section 2502 of the Afghanistan Supplemental Appropriations Act, 2022, and the Consolidated Appropriations Act of 2023; or
    • Certain Ukrainian parolees under Section 401 of the Additional Ukrainian Supplemental Appropriations Act of 2022 (AUSAA) and the Ukraine Security Supplemental Appropriations Act of 2024 (USSAA).
    • Call the Change Report Center at 302-571-4900, Option 2
    • Online: ASSIST
    • Visit your local DHSS office

    Even if your Medicaid benefits do not change, the new rule may change coverage for someone else in your household. Be sure to check with your local office before September 1, 2026. Consider talking with your doctors about care you may need to receive now in case you do lose your Medicaid coverage on October 1, 2026.

    Need help or have questions?

    Call the Delaware Medicaid Customer Relations Unit at 1-866-843-7212 (TTY: 711)
    Español, Kreyòl ayisyen, ة ي ب ر ع ل ا, 中文, or other languages: 1-866-843-7212

    New federal Work and Community Engagement requirements begin January 1, 2027

    New rules are also coming soon for people who are currently covered as part of the Adult Medicaid Expansion group (low-income adults ages 19 through 64 who became eligible for Medicaid coverage under the Affordable Care Act). While these changes don’t go into effect until January 1, 2027, Delaware is sharing this information now to give you time to meet the new requirements.

    Starting January 1, 2027, you must work and earn at least $580 a month or complete at least 80 hours a month:

    • Working;
    • Volunteering or doing community service;
    • Taking part in a work program; and/or
    • Going to school or job training at least part-time

    The new federal rule applies to you if you are:

    • Between the ages of 19 – 64;
    • A U.S. citizen, U.S. National, or an immigration status that allows you to have full Medicaid;
    • Physically and mentally able to work and do not qualify for an exemption (see the FAQs below for reasons you may not have to meet the new requirements);
    • Not the parent, guardian, or caregiver relative of a dependent child age 13 and under, or an individual with disabilities.

    If you are able to work and not already meeting the new federal work and community engagement requirements, support is here:

    Medicaid renewals will happen every six months.

    Starting in 2027, your Medicaid will need to be renewed every six months instead of once a year under the old federal rules. When it is time for your renewal, your Medicaid case manager will check the information we already have about you. If we need more information, we will ask you for things like pay stubs, school papers, or proof of your volunteer or work program hours. If you do not provide this information on time, you could lose your Medicaid benefits.

    Important: You must tell us if any of these things change, even if it is not time for your next renewal:

    • Your work hours, pay, or income;
    • Your health (disability, hospital stays, treatment programs);
    • School, training, volunteering, or work programs;
    • Your household size (pregnancy, marriage, divorce, adoption);
    • Where you live, including if you are in jail;
    • Your address or contact information.

    Ways to report changes:

    • Call 302-571-4900, Option 2
    • Online: ASSIST
    • Mail or drop off your information at your local DHSS office

    The rules on who qualifies for full Medicaid coverage will soon change because of a new federal law. Some of these rules have to do with immigration status for non-citizens. Other rules require people to meet new work and community engagement requirements to keep their Medicaid coverage. Eligibility for benefits must also be renewed more often for certain members.

    Please read this information carefully to see if the new rules apply to you or someone in your household. Check this page often as Delaware is still waiting for updates from the federal government about the new rules. As we learn new information, we will share it on this page.

    Starting October 1, 2026, you must be in the country under one of these immigration statuses to receive full Medicaid coverage:

    • Lawful Permanent Residents with a Green Card who:
      • Have completed the five-year waiting period, or
      • Have an immigration status that did not require the five-year waiting period;
    • Cuban or Haitian entrants;
    • COFA migrants (citizens of the Marshall Islands, Micronesia, or Palau living in the United States under the Compact of Free Association, or COFA);
    • Pregnant women and children may qualify for full Medicaid even if your immigration status is not on the above list. This is because pregnant women and children have different rules under Delaware’s elected CHIPRA 214 option.

    If you are a refugee, you may be eligible for Refugee Medical Assistance coverage in the first four (4) months of your refugee status. After those four months end, you may still be eligible for emergency services and labor and delivery services.

    If your immigration status has changed, update your information before September 1, 2026:

    • Call the Change Report Center at 302-571-4900, Option 2
    • Online: ASSIST
    • Visit your local DHSS office.

    Starting January 1, 2027, you must work and earn at least $580 a month or complete at least 80 hours a month:

    • Working;
    • Volunteering or doing community service;
    • Taking part in a work program; and/or
    • Going to school or job training at least part-time.
    • New federal Medicaid coverage requirements for noncitizens go into effect October 1, 2026.
    • New federal work and community engagement requirements for those in the Medicaid Expansion group go into effect January 1, 2027.
    • New six-month renewals for those in the Adult Expansion Group go into effect January 1, 2027.  

    Under the Affordable Care Act, the Medicaid Expansion group includes low-income adults, ages 19 through 64 — including those without dependent children — with household incomes up to 133% of the federal poverty level. These individuals currently qualify for Medicaid based on income alone (regardless of disability or family status) but will now have to meet or prove they qualify for an exemption from the new work and community engagement requirements.

    Yes, you must be able to prove you meet federal work and community engagement requirements when you apply for Medicaid the first time, and then your eligibility must be renewed every six months. If you are applying for Medicaid for the first time, you must be able to show that you met work requirements for at least one month leading up to your application. You may need to show us documents such as pay stubs, school papers, or proof of your volunteer or program hours. If you do not provide this information on time, you could lose your Medicaid benefits.

    You may be exempt from (not have to meet) the new federal work and community engagement requirement if you are:

    • Under age 26 and were in foster care;
    • A member of a federally recognized tribe;
    • A parent, caretaker, guardian of a child aged 13 or younger, or family caregiver for a person with a disability;
    • A veteran with a total disability rating of 100%;
    • Have serious health needs, such as:
      • Blindness or disability,
      • Substance use disorder,
      • Mental health condition,
      • Serious medical condition,
      • Other physical or developmental disability that makes it hard to do daily activities;
    • You already meet work rules through SNAP or TANF (SNAP is the Supplemental Nutrition Assistance Program and TANF is Temporary Assistance for Needy Families);
    • You are in a drug or alcohol treatment program;
    • You are in jail or were in jail in the last 90 days;
    • You are pregnant or receive Medicaid extended postpartum coverage.

    Temporary Hardship Exemptions

    You may not need to meet the rules for a short time if:

    • You were in the hospital or a nursing home in the last 12 months;
    • You or your dependent had to travel outside your community to receive care for a serious health condition in the last 12 months;
    • You live in an area with a government declared emergency; or
    • You live in an area with high unemployment rate.

    Be sure to check your texts, email, DHSS ASSIST account and U.S. mail for messages from DHSS. These important notices will tell you if there are things you need to do to keep your Medicaid coverage.

    Before your renewal date, we will mail you a notice letting you know if your coverage has been renewed (continued), or if you need to provide proof that you either meet the requirement or qualify for an exemption.

    Things may change, so be sure to check this page often for the most up-to-date information about Medicaid changes. You can also follow DHSS on social media for Medicaid ENGAGE news and reminders:

    You may be exempt from the new Medicaid work requirements if you have serious health needs such as:

    • Blindness or disability;
    • Substance use disorder;
    • Mental health condition;
    • Serious medical condition; or
    • Other physical or developmental disability that makes it hard to do daily activities.

    You will need to give your Medicaid case manager a form completed and signed by your doctor.

    If you are a parent, caretaker, guardian of a child aged 13 or younger, or you are a family caregiver for a person with a disability, you may be exempt from (not have to meet) the new rules do not apply to you.

    For help with employment, training, and education, visit a Delaware Department of Labor office, call 302-761-8085, or visit https://joblink.delaware.gov.

    You must tell your Medicaid case manager if your work hours, pay or income change, even if it is not time for your next renewal. If you need help with employment, training, and education, visit a Delaware Department of Labor office, call 302-761-8085, or visit https://joblink.delaware.gov

    Ways to report changes:

    • Call 302-571-4900, Option 2
    • Online: ASSIST
    • Mail or drop off your information at your local DHSS office

    Yes, you can apply for Medicaid again at any time once you are able to meet the requirements or prove you qualify for an exemption.

    You will need to renew your Medicaid coverage every six months instead of every 12 months. Watch your mail, texts and email or ASSIST account for notices of when it is time for your next renewal.

    Update your contact information. If your address, phone number, or email changes, update it right away. DHSS uses this information to send you important updates.

    Report a change in your income or household. You must report certain changes within 10 days. Some of these changes may affect whether you must meet the new work requirements or a six-month renewal.

    Renew your coverage on time. When you get your renewal notice, complete it before the due date to avoid gaps in coverage.

    Ways to report changes:

    • Call 302-571-4900, Option 2
    • Online: ASSIST
    • Mail or drop off your information at your local DHSS office
    • Call the Delaware Medicaid Customer Relations Unit at 1-866-843-7212 (TTY: 711) or visit your local DHSS office.
    • Visit this page often for the most up-to-date information about Medicaid changes.
    • Follow DHSS socials for Medicaid ENGAGE news and reminders.

    Español, Kreyòl ayisyen, ة ي ب ر ع ل ا, 中文, or other languages: 1-866-843-7212