Starting a new job is an exciting milestone but if you receive Medicaid benefits in states like North Carolina, South Carolina, Tennessee, Alabama, or Maryland, it also comes with important reporting obligations.

Because Medicaid is a need-based program, any change in income can directly affect your eligibility. Understanding what to report and when can help you avoid overpayments, penalties, or an unexpected loss of coverage. Below is what you need to know to stay compliant and protect your benefits in 2026.

Do You Have to Report a New Job to Medicaid?

Yes. In most states, you are legally required to report any change in income. This applies whether you are starting full-time employment, switching jobs, or receiving a raise. Medicaid programs rely on this information to determine continued eligibility. Failing to report changes can result in overpayment notices, meaning you may have to repay the state for services received while you were technically ineligible.

The 10-Day Reporting Rule (2026 Update)

In the states we serve (NC, SC, TN, AL, and MD), the general requirement is to report income changes within 10 daysof receiving your first paycheck. You must report:

• Your new employment start date.

• The amount of your first paycheck.

• Changes in weekly work hours.

2026 Medicaid Income Limits

As of 2026, many long-term care and waiver programs use an individual income limit of approximately $2,982 per month. To ensure you are meeting the correct standards for your specific category, it is helpful to cross-reference the official federal Medicaid eligibility guidelines.

How to Report Your New Job by State

Each state utilizes a specific system for processing these updates:

• North Carolina: ePASS portal.

• South Carolina: Healthy Connections.

• Maryland: Maryland Health Connection.

• Alabama & Tennessee: Local county Medicaid or DHR office.

Will You Lose Coverage?

Not necessarily. Many individuals transitioning into the workforce qualify for Transitional Medical Assistance (TMA), which can extend coverage for up to 12 months while you adjust to your new role and wait for employer-sponsored insurance to begin.

Protecting Your Benefits with Legal Guidance

At Johannesmeyer & Sawyer, PLLC, we help families navigate the complexities of Medicaid eligibility and asset protection. If you have recently started a new job, early planning is essential to avoid coverage gaps or financial penalties.

Visit our website for more information on Medicaid planning: www.jandspllc.com

Call us to find out more about your 2026 Medicaid planning options.