Medicaid redetermination is the periodic review in which a state Medicaid agency checks whether an enrollee still meets eligibility rules for coverage. States generally renew eligibility every 12 months, using available data first and contacting enrollees when information is missing.
Under the 2025 federal budget reconciliation law, states must redetermine eligibility every 6 months for Medicaid expansion adults, for renewals scheduled on or after December 31, 2026. More frequent renewals mean more outreach, more paperwork and more risk that eligible people lose coverage for procedural reasons such as an outdated address or a missed form.
State agencies run the eligibility decision. Managed care plans and community partners help by reminding members, updating contact information and helping them complete renewal steps.
Ushur AI agents run multilingual outreach over SMS, voice and web, help members update contact details and complete renewal steps, and escalate to staff when needed. See Medicaid redetermination for health plans and for public sector agencies.