Apply for Medicaid

No. Alaska does not use provider taxes or state-directed payments (SDPs), which are financing mechanisms many other states rely on to draw down additional federal Medicaid funds. 

• Provider taxes are fees that states collect from hospitals or other healthcare providers, which can be used to increase Medicaid payments and trigger higher federal matching funds. 
• State-directed payments are special payment arrangements that allow states to direct how managed care plans pay certain providers, often resulting in higher provider reimbursement. 

Because Alaska’s Medicaid program does not use these tools, it is not affected by the bill’s provisions that restrict or reduce funding tied to provider taxes and SDPs.

Beginning July 1, 2028, states may create new “needs-based” HCBS waivers under section 1915(c) for individuals who require support but do not meet an institutional level of care. This new waiver type is intended to offer flexibility to design services around state-defined needs-based criteria. 

Services under these waivers cannot include room and board and must cost less than institutional care. States can cap enrollment but cannot use these waivers to delay access for people eligible for traditional HCBS waivers. 

Alaska already has HCBS waivers in place that provide similar services, but this bill provides support to states looking to establish a new option through implementation funding ($100 million nationally) and simplified federal review.

No. Alaska’s HCBS programs are established through long-standing Medicaid waivers that remain in place. These services are critical for helping seniors and people with disabilities receive care at home or in their communities, rather than in institutions. Alaska remains strongly committed to sustaining and expanding this model of care, and will continue investing in community-based supports as part of its overall approach to Medicaid.

The bill requires states to charge copayments for some Medicaid expansion enrollees with incomes above 100% of the federal poverty level, starting in 2028. There are limits on how much a state can charge. For example, copayments cannot be more than $35 or a certain percentage of an individual’s income.  

Alaska already has copayments in place for certain enrollees for many services, including hospital visits, outpatient care, and prescriptions. The state is assessing whether any changes to copayments are needed before the federal effective date.

Starting January 1, 2028, states can choose to raise the home equity limit used to determine eligibility for long-term care services.

Right now, Alaska’s limit is $500,000. Under the new law, Alaska could raise the limit to $1 million. This change would help more Alaskans qualify for long-term care coverage without being disqualified because their home is worth more than current limits.

Not immediately. Currently, states can avoid federal penalties for Medicaid payment errors (such as covering ineligible individuals) if they act in good faith to correct them. The bill ends this waiver in 2030.  

Starting then, states may face financial penalties if more than 3% of their Medicaid cases have errors.

No. Many adults in the Medicaid expansion group will have their eligibility reviewed every 6 months instead of every 12 months. Medicaid recipients who are not subject to the 6-month review rule will continue to have a 12-month review cycle.

Your review schedule depends on your Medicaid eligibility group. People in the same household may also have different review schedules.

No. They are separate requirements.

A 6-month renewal determines whether you still qualify for Medicaid. Medicaid Work and Community Engagement Rules apply to some adults in the Medicaid expansion group and may be one part of the eligibility review for people who are subject to them.

Being excluded from the Medicaid Work and Community Engagement Rules does not automatically mean you are excluded from 6-month Medicaid renewals.

Alaska Native and American Indian individuals in the Medicaid expansion group will continue to have a 12-month renewal cycle. All others in the Medicaid Expansion population will have 6-month renewals, even if they qualify for an exclusion. 

Not necessarily. The Division of Public Assistance (DPA) will first use information available to determine whether your Medicaid can be renewed without asking you for additional information.

If DPA needs information from you to complete the renewal, you will receive a renewal form or notice explaining what information is needed and when it is due.

No. A 6-month renewal means the Division of Public Assistance will review your eligibility every 6 months if the rule applies to you.

If you remain eligible at your renewal, your Medicaid coverage can continue into the next eligibility period.

Yes. The Division of Public Assistance will send you a renewal notice or request for information when action is needed.

Keep your contact information current and respond by the date shown on the notice.

If the Division of Public Assistance can determine that you remain eligible using information already available, you may not need to provide additional information.

You will receive a notice telling you the result of your renewal.

Not necessarily. Alaska is transitioning people to 6-month renewals using their existing renewal schedule when possible.

If your renewal schedule changes, the Division of Public Assistance will notify you.

Most Medicaid recipients will continue to have their eligibility reviewed every 12 months. This includes Alaska Native and American Indian individuals and people who qualify for Medicaid based on circumstances such as age, disability, or pregnancy.

Your review schedule depends on the Medicaid eligibility group you are enrolled in.

Yes. Medicaid eligibility is determined separately for each person. One household member may have eligibility reviewed every 6 months while another household member remains on a 12-month review cycle.

A new federal law changes which citizenship and immigration statuses can qualify for full Medicaid beginning October 1, 2026. Alaska must review people who may be affected and apply the new federal rules.

What you should do:

• Make sure your address, phone number and email address are up to date so we can contact you
• Open and respond to any renewal form or request for information by the date shown

What you need to know:

• DPA will check records we already have first and we will only ask for documents if we have to
• A change for one person does not automatically end Medicaid for everyone in the household

Changes to the federal program which citizenship and immigration statuses can qualify for full Medicaid beginning October 1, 2026. Alaska must review people who may be affected and apply the new federal rules.

Some immigration statuses that currently qualify for full Medicaid may no longer qualify under the new federal law. U.S. citizens and U.S. nationals are not affected by this change. Some noncitizens will remain eligible, including people in certain federally recognized categories. Because the rules are detailed and each person’s situation is different, DPA must review each case before making a decision.

People enrolled in Medicaid whose immigration status may no longer qualify for full Medicaid under the new federal rules may be affected. Receiving a letter or renewal form does not mean a final decision has been made.

The letter gives advance notice that the federal rules are changing and that DPA may need to review Medicaid eligibility for you or someone in your household.

No. The Director’s letter is for information only. Please watch your mail. If DPA sends you a renewal form or a request for information, read it and reply by the date shown.

No. First, DPA will check the information the State already has. Some people will not need to do anything. Others will get a renewal form or be asked to send more information.

Read it carefully and reply by the date shown. Send the information requested. Call DPA if you need help, need a language interpreter, did not receive the form, or cannot get a requested document.

DPA will first check the information the State already has. DPA should not ask you for the same information again unless something is missing, unclear, outdated, or conflicts with another record.

SAVE is a federal system that checks citizenship or immigration information for benefit programs. If SAVE cannot confirm your information right away, it does not mean you are not eligible for benefits. DPA may just need more information or more time to finish reviewing your case.

DPA will complete a full Medicaid review. This may include citizenship or immigration status, income, household information, age, pregnancy, and other Medicaid rules. DPA must also consider any other Medicaid coverage that may apply before changing coverage.

Call DPA as soon as you can. Do not assume your benefits will stop. DPA will check whether the information can be verified through records already available or whether another document may be accepted. If you are having difficulty getting the requested information, tell DPA so staff can explain your options and determine whether additional time may apply.

It is extra time to verify citizenship or an eligible immigration status when a person says they have an eligible status but DPA cannot verify it right away. When federal rules require it, Medicaid continues during this period.

No. It means DPA needs to review eligibility. DPA must complete the review, consider available information, and send a written notice explaining the outcome. Medicaid will not change unless DPA completes the review and sends the required notice.

Yes. Medicaid eligibility is reviewed for each person. A change for one person does not automatically end Medicaid for everyone in the household.

Yes. DPA will send a written notice explaining the outcome of the review. If your Medicaid continues, the notice will explain your eligibility. If DPA changes or ends coverage, the notice will also explain the reason, effective date, appeal rights, and how to get help.

Yes. The formal eligibility notice will explain how and when to request a fair hearing and whether coverage may continue while the appeal is pending.

Emergency Medicaid is limited coverage for treatment of an emergency medical condition for a person who meets other Medicaid rules but does not qualify for full Medicaid because of citizenship or immigration status. It does not cover all ongoing or routine health care.

Call the Alaska Division of Public Assistance at 1-800-478-7778. Free interpreters are available. For Alaska Relay, call 7-1-1.