public-service · Medicaid MAGI renewal rules
Medicaid MAGI Renewals: The 12-Month Limit and 90-Day Window
Federal rule 42 CFR 435.916 caps Medicaid MAGI renewal frequency at once per 12 months and sets a 90-day post-termination reconsideration window.
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Updated: Sources: 1
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What matters now
- MAGI-based Medicaid eligibility can be renewed no more than once every 12 months.
- A termination for missing renewal paperwork must be reconsidered without a new application if it arrives within 90 days.
- States may extend the 90-day reconsideration window, but cannot shorten it below the federal floor.
- The current regulatory text carries a Federal Register citation dated June 3, 2026.
For Medicaid beneficiaries whose financial eligibility is determined using MAGI (Modified Adjusted Gross Income), federal rule 42 CFR § 435.916 sets two procedural floors: a state cannot require renewal of eligibility more often than once every 12 months, and if a beneficiary is terminated for failing to submit the renewal form or necessary information, the state must reconsider that person’s eligibility without a new application if the missing paperwork arrives within 90 days of the termination date.
This original record-reading guide is a general reading aid, not cited evidence. It does not depict a source record; the article text and source links provide the facts.
Key points
- Renewal of MAGI-based Medicaid eligibility “must be renewed once every 12 months, and no more frequently than once every 12 months” (42 CFR § 435.916).
- If a beneficiary is terminated for not submitting the renewal form or necessary information, and then submits it within 90 days of termination, the state must reconsider eligibility without requiring a new application (42 CFR § 435.916).
- A state may elect a reconsideration window longer than 90 days, but the regulation sets 90 days as the federal floor (42 CFR § 435.916).
- The current regulatory text carries the citation “[91 FR 33480, June 3, 2026]” (42 CFR § 435.916).
State renewal frequency
The regulation states that MAGI-based Medicaid eligibility “must be renewed once every 12 months, and no more frequently than once every 12 months” (42 CFR § 435.916). This is a floor and a ceiling in one: a state cannot go longer than 12 months between renewals, and it cannot demand renewal more often than that 12-month cycle.
Missing-paperwork termination
If a beneficiary loses Medicaid because they did not submit the renewal form or other necessary information, the regulation requires the state to “reconsider in a timely manner the eligibility of an individual who is terminated for failure to submit the renewal form or necessary information, if the individual subsequently submits the renewal form within 90 days after the date of termination, or a longer period elected by the State, without requiring a new application” (42 CFR § 435.916). In plain terms: submitting the missing renewal form or information within 90 days of termination entitles the person to a timely eligibility reconsideration, and the state cannot force them to start over with a brand-new application.
The regulatory citation on record
The current version of this section carries the citation “[91 FR 33480, June 3, 2026]” (42 CFR § 435.916), marking the Federal Register source and date associated with the text quoted above.
What this article does not cover
This article states only the federal procedural floor found in 42 CFR § 435.916 for MAGI-based Medicaid eligibility groups. It does not describe how any particular state implements renewal notices, sets its own deadlines, or handles a beneficiary’s address of record — those details vary by state and are not part of the quoted federal text. It does not determine or speak to any individual’s actual Medicaid eligibility or case outcome. And it does not address non-MAGI eligibility groups (such as eligibility based on age, blindness, or disability determinations), because the quoted paragraph applies specifically to MAGI-based determinations and does not cover those other groups.