Starting a new position is a significant milestone, but if you are currently receiving Medicaid, it often raises a vital concern: will you lose your coverage if you start working?
The answer is not always straightforward. In many cases, you can begin working and still keep Medicaid—at least temporarily or under specific program rules. However, your income level, household size, and state regulations in NC, SC, TN, AL, and MD all play a role in determining your continued eligibility.
Does Getting a Job Automatically Cancel Medicaid?
No. Getting a job does not automatically cancel your Medicaid coverage. Eligibility is based on income and your specific program category, not solely on your employment status. This means:
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You can be employed and still qualify for benefits.
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You can work part-time and remain eligible.
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You may transition off Medicaid gradually depending on your total income.
However, you are legally required to report any changes in income to your state Medicaid office.
How Employment Affects Your Eligibility
When you start working, Medicaid will reassess your status based on your monthly income, household size, and state-specific income limits. For many categories—especially long-term care or waiver programs—the approximate individual income limit is:
$2,982 per month
If your income exceeds this amount, you may lose eligibility for certain Medicaid programs, though coverage loss is not always immediate. For a deeper look at the national standards, you can review the latest official Medicaid eligibility guidelines.
The Safety Net: Transitional Medical Assistance (TMA)
One of the most important protections for working Medicaid recipients is Transitional Medical Assistance (TMA). TMA may allow you to keep your Medicaid coverage for up to 12 months after your income increases. This program is designed to help you:
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Adjust to your new income without losing healthcare.
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Obtain employer-sponsored insurance during the transition.
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Avoid dangerous gaps in healthcare coverage.
The 10-Day Reporting Rule
In the states we serve (North Carolina, South Carolina, Tennessee, Alabama, and Maryland), you must generally report a new job within 10 days of starting or receiving your first paycheck. Failing to report can lead to overpayment claims or a retroactive termination of benefits.
How to Report by State:
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North Carolina: ePASS portal
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South Carolina: Healthy Connections
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Maryland: Maryland Health Connection
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Alabama & Tennessee: Local county Medicaid or DHR office
Protecting Your Benefits With Legal Guidance
At Sawyer & Associates, LLC, we help families across the Southeast and Mid-Atlantic navigate Medicaid rules, income changes, and asset protection strategies. Planning ahead helps you transition into your new career safely while protecting your healthcare benefits.
Visit our website for more information on Medicaid planning: sawyer-law.com
Call us to find out more about how your new job affects your Medicaid eligibility.
