If Nevada Medicaid Sent You a Letter This Month, Read This First

By Mary Jones, licensed independent broker, Henderson. Last reviewed September 25, 2026.

About 250,000 letters are going out across Nevada this month. Most of the people opening them are going to be fine.

Nobody pays me when somebody keeps their Medicaid. Brokers don't earn a cent on it. I'm writing this anyway, because the letter is confusing and because the law behind it has a trap that deserves plainer words than it's getting.

The short version. Starting January 1, 2027, adults 19 to 64 on expansion Medicaid have to show 80 hours a month of work, school, job training or community service, or fit an exemption. Renewals move to every six months. And anyone who loses Medicaid over the work rule is also blocked from marketplace tax credits. So the goal is to keep it.

What the letter is about

Nevada Medicaid started mailing these the first week of September, with texts and emails following through the end of the month. They're informational. Nothing gets cut off because a letter arrived.

The rule comes from the federal budget law signed in July 2025. Beginning January 1, adults between 19 and 64 who got Medicaid through the expansion have to verify 80 hours a month of qualifying activity. Work counts. So does job training, school, community service, or a mix. So does earning at least $580 a month. Renewals change too. Once a year becomes every six months.

Most people getting a letter are excluded or already meet the requirement. That's the state's own read. Administrator Ann Jensen put it this way: "No one should lose coverage simply because they weren't aware of the new requirement."

I agree with her. I also know how mail works.

Who the rule skips

The list is long and worth reading slowly, because an exemption nobody claims doesn't count. Pregnant and postpartum women. People with disabilities or serious medical conditions. Parents and caretakers of a child 13 or younger. People collecting unemployment. People in drug or alcohol treatment. People who are incarcerated.

Nevada is also asking the federal government to approve short-term hardship exemptions: for people who travel far for care, people hit by a natural disaster, people in high-unemployment counties, people just out of the hospital.

Two ways to lose Medicaid, and they are not the same

This is the part I'd tape to the fridge.

The first way is an income loss. A raise comes through, or the hours pick up, and your income climbs past the Medicaid line. That's the good kind of problem. Losing Medicaid that way opens a 60-day window to enroll through Nevada Health Link, and unless the new job comes with its own coverage, a tax credit will usually pay part of the premium. I help people through that handoff all year.

The second way is a paperwork loss. You were working the whole time, or exempt the whole time, and the state never found out. A letter went to an old address. A renewal date slid by. The hours never got reported. An exemption never got claimed. Medicaid ends, and here is the trap: under that same federal law, a person who loses Medicaid for not meeting the work requirement cannot get marketplace tax credits. The plans are still for sale. The full price is yours.

An income loss has a soft landing built in. A paperwork loss doesn't. Same word on the notice, completely different week.

For somebody living on $1,400 a month, full price might as well be no plan at all.

So the whole game is keeping it

None of this is complicated. All of it is easy to miss.

Make sure Medicaid has your current address and a phone number that works. Find your renewal date and write it somewhere you'll see it, because renewals now come twice a year and the work requirement gets checked at each one.

If you're working, keep pay stubs. If you're exempt, say so, through whatever channel the letter gives you. The state doesn't know your kid is eleven. It doesn't know you're in treatment.

If a notice ever says you're out of compliance, the clock is short. Federal rules give you 30 days to show you meet the requirement or qualify for an exemption, and you have the right to a hearing. Answer it the day it arrives.

And watch for scammers, who love a confusing letter. Nevada Medicaid says it will never ask for payment or sensitive personal information by phone or text. The real information lives at nevadamedicaid.nv.gov/WorkRequirements.

If your letter says October 1

A smaller group got a different letter. About 5,000 legally present immigrants in Nevada lose Medicaid on October 1, no matter how many hours they work. That's a separate rule with its own clock, and the marketplace tax credit rules for immigrants change again on January 1. Don't let that letter sit. Call me this week, or find a free navigator through Nevada Health Link.

Where I come in, and where I don't

If you're staying on Medicaid, you don't need me, and I'm glad. Keep the file and keep the dates.

If your income is about to cross the line, or already has, that's my side of the fence, and it doesn't have to wait for any enrollment season. The 60 days starts when Medicaid ends. You can start up to 60 days before that. Find My Coverage will point you at the right door in a couple of minutes, or call me at (702) 379-9084. It costs nothing.

Two hundred fifty thousand letters. The ones that worry me are sitting unopened on a counter in an apartment somebody moved out of in June.

Quick answers

When do Nevada Medicaid work requirements start? January 1, 2027. Nevada Medicaid began mailing informational letters in early September 2026.

How many hours do I have to work to keep Nevada Medicaid? 80 hours a month of work, job training, education or community service, in any mix. Earning at least $580 a month also meets the requirement.

Who is exempt from Nevada Medicaid work requirements? Pregnant and postpartum women, people with disabilities or serious medical conditions, parents and caretakers of a child 13 or younger, people on unemployment, people in drug or alcohol treatment, and people who are incarcerated. Exemptions have to be claimed.

Can I get marketplace subsidies if I lose Medicaid over the work requirement? No. Federal law makes people who lose or are denied Medicaid for not meeting the work requirement ineligible for premium tax credits. People who lose Medicaid because their income rose can generally qualify.

Sources: Nevada Current, September 4, 2026 and July 22, 2026; KFF on the work requirement provisions; Nevada Health Link, special enrollment; Nevada Medicaid.

I can't tell you whether you qualify for Medicaid or for an exemption. Nevada Medicaid decides that. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact HealthCare.gov to get information on all of your options. This article is general information, not legal, tax, or financial advice. Mary Jones, Jones True Insurance Solutions, Henderson, NV. NPN #20192176.