What is a Medicaid request for information?

It is your state asking you to prove something it could not confirm from the records it already has. Common triggers include a mismatch between reported income and database records, a reported change in circumstances, information received from a third party, or an incomplete renewal form.

How long do I have to respond to a Medicaid request for information?

At least 30 days from the date on the notice. States may allow longer but not shorter. The clock runs from the notice date rather than the date you received it.

What happens if I miss the Medicaid document deadline?

Your coverage can be terminated for failure to provide the information. If you then submit it within 90 days of the termination date, your state must reconsider your eligibility without requiring a new application. Some states allow longer than 90 days.

Can I keep Medicaid coverage while I appeal a termination?

Coverage can be continued while a fair hearing is decided, but only if the hearing is requested within the short timeframe stated on your notice. The notice is required to explain the circumstances under which Medicaid continues if a hearing is requested.

Do I need documents, or is a written explanation enough?

Where a discrepancy between your reported information and an electronic data source is at issue, a statement that reasonably explains the difference can be acceptable in place of documentation. Read your notice for what is specifically being requested.

← All guides

Medicaid request for information: what to send, and by when

Also called a request for verification, a proof request, or a notice of missing information.

The short version: your state cannot confirm something about your case from the records it already has, so it is asking you to prove it. You have at least 30 days from the date on the notice to respond. If you do not, your coverage can be terminated — not because you were found ineligible, but because the question was never answered. Send something before the deadline even if you cannot send everything.

Why you got this

Medicaid is joint federal-state health coverage for people who qualify on income and circumstances. Your state checks eligibility using electronic data sources first — wage records, tax data, other government databases. Most of the time that works and you never hear anything.

This notice means the automatic check did not settle it. Usually one of these:

The numbers do not line up. What you reported and what the databases show are far enough apart that the state has to ask. This is the most common reason, and it is often a timing difference rather than an error — you changed jobs, hours dropped, or a database is simply out of date.
Something changed and needs confirming. A new address, a change in household size, a new job.
A third party reported something. Before the state can act on information it received from somewhere else, it has to give you the chance to confirm or dispute it.
The renewal form came back incomplete. A missing signature or a blank section produces a follow-up request rather than a rejection.

None of these mean you have done anything wrong, and none of them mean a decision has already been made.

What to send

Read the notice for the exact list — it varies by what is being verified. Commonly requested:

Proof of income: recent pay stubs, an employer letter, or a benefit award letter. If you are self-employed, a profit-and-loss summary or tax return.
Proof of address: a utility bill or lease.
Household details: confirmation of who lives with you and their relationship to you.
An explanation. This one gets overlooked. Where a discrepancy is at issue, a written statement that reasonably explains it can be acceptable — you do not always need a document. If your hours were cut in March and the database still shows last year's wages, saying so in writing may be enough.

Send it whichever way you can prove it went. Keep a copy of everything, note the date you sent it, and screenshot the confirmation if you upload. If you mail it, keep the envelope — postmarks matter if a dispute arises about timing later.

Send something even if it is incomplete. A partial response with a note explaining what is still coming is far better than silence. Silence is what triggers termination. A partial response keeps your case active and shows you engaged before the deadline.

Deadlines to watch

At least 30 days from the date on the notice to respond. Your state can allow more, not less. The clock runs from the notice date, not the day it arrived.
10 days' advance notice is required before your state actually terminates coverage, so a termination letter should not be the first thing you see.
90 days after termination to send the information in and have your eligibility reconsidered without filing a new application. Some states allow longer.

Two protections worth knowing

If the change would help you, they cannot cut you off for not proving it

If you report a change that would increase your assistance or lower your premiums or cost sharing, and the state cannot verify it, it is not permitted to terminate your coverage for failing to respond to that particular verification request. The change may not be applied, but your existing coverage is not the price of failing to document it.

Coverage can continue while you appeal

If your coverage is being terminated and you request a fair hearing, coverage can be continued while the hearing is decided — but only if you request it within the timeframe your notice specifies, which is short. The notice is required to explain the circumstances under which Medicaid continues if a hearing is requested. Read that part before anything else if you are facing termination.

One more: before your state can find you ineligible, it has to consider whether you qualify under any other Medicaid category, not just the one you are enrolled under.

What happens if you ignore it

Coverage ends for failure to provide the information — a procedural termination, not a finding that you do not qualify. Most people terminated this way were still eligible.

The 90-day reconsideration window is the safety net, and it is genuinely useful, but it is not a substitute for responding on time. Between termination and reinstatement you are uninsured, and medical costs incurred in that gap may not be covered retroactively.

Is this letter real, or a scam?

Requests for documents are exactly what fraudsters imitate, since the ask feels legitimate. Signs of a fake:

It asks you to pay a fee to submit documents or keep coverage. Medicaid charges nothing for this.
It wants your full Social Security number or bank details confirmed by phone or through a link in a text message.
It threatens coverage ending today or within 24 hours. Real notices give you at least 30 days.
It comes from an official-sounding body that is not your state Medicaid agency.

If unsure, do not use the number or link in the message. Look up your state Medicaid agency yourself, or call the number on your Medicaid card.

Free help exists

Legal aid organisations in every state handle Medicaid cases at no charge, and many will help you assemble a response or request a hearing. If you are facing termination and the paperwork feels beyond you, this is worth a call before the deadline rather than after it.

Not sure what your specific notice is asking for?

Upload it and get a plain-English explanation of what it says, what it wants from you, and what your deadline is. No account needed. $4.99, one letter.

Explain my letter

Related guide

Medicaid renewal packet: what it means and what to do — if this request followed a renewal form you already sent back.

Sources

MyPlainLetter is an independent service. It is not affiliated with, authorized by, or endorsed by any federal or state government agency. This page is general information about how Medicaid verification requests work — it is not legal, medical, or benefits advice, and rules vary by state. For a decision about your own case, contact your state Medicaid agency or a free legal aid service.