Medicaid Work Requirement Exemptions: Who Qualifies?

September 25, 2026

Senior woman reviewing new Medicaid work requirements online at her table

If you’ve heard about the new Medicaid work requirements and wondered whether they apply to you or someone you love, you’re not alone. This is one of the most common questions our care coordinators are hearing right now. Here’s a clear answer.

What Are the New Medicaid Work Requirements?

Some adults on Medicaid will soon need to show 80 hours a month of work, school, job training, or volunteering to keep their coverage. This is often called a community engagement requirement, and it’s part of a new federal law affecting Medicaid nationwide, according to CMS’s official announcement. There’s a lot to unpack in that requirement, but here, we’re focusing on the question we hear most: am I exempt?

When Do Medicaid Work Requirements Start?

The new requirements begin January 1, 2027. They’ll be reviewed when you apply for Medicaid or come up for renewal on or after that date, not before. New York State has already begun mailing notices to anyone the rule applies to, so if you or a family member receives one, that’s expected and worth reading closely. You can also check NY State of Health’s official update page for the latest. 

Who Is Exempt from Medicaid Work Requirements?

This is the part that matters most for most of our families: the majority of people receiving home care through True Care are exempt.

You’re generally exempt from the work requirement if you are:

  • 65 or older
  • Living with a disability, or have a health condition that makes working difficult
  • A caregiver for a disabled family member or a child under 14
  • Pregnant, or were pregnant in the last 12 months
  • Enrolled in Medicare Part A or Part B
  • American Indian or Alaska Native
  • Already meeting SNAP or TANF work requirements
  • In a drug or alcohol treatment program
  • In or recently aged out of foster care (exempt until age 26)
  • A veteran with a total disability
  • Currently in jail or prison, or released in the last 3 months

You can see the full state-issued list here.

If you’re receiving home care through True Care because of your age or a medical condition, this requirement most likely does not apply to you.

There are also a few temporary exceptions, for example, if you were recently hospitalized, had to travel for medical care unavailable in your area, or live somewhere affected by a declared emergency or high unemployment. New York State will generally let you know if one of these applies to you.

What Should You Do If You’re Not Sure You’re Exempt?

You may need to show proof of your exemption when you renew Medicaid, so it’s worth confirming your situation before a deadline is on the table. A few things worth doing now:

  • Open any mail from New York State of Health, even if it doesn’t seem urgent.
  • If you’re a caregiver for a family member, keep documentation of that role on hand.
  • If you’re unsure where you stand, ask before you assume, exemption categories can be specific, and it’s easy to miss one that applies to you. Our True Care team is here to help you work through that.

Not sure where to start? Reach out to our team, we’re happy to help.

How True Care Can Help with Medicaid Work Requirement Exemptions

Figuring out whether an exemption applies to you shouldn’t feel like a research project. Our care coordinators can help you understand any notice you receive, confirm where you stand, and pull together documentation if you need to prove an exemption at renewal. If you’re already a True Care client, we can also coordinate directly with your care plan, so nothing falls through the cracks.

You don’t have to wait for a notice to reach out. If you have questions now, we’re happy to help before anything is due. Contact the True Care team today.

True Care is a Licensed Home Care Agency providing personalized home health care and support services to families throughout New York City, Westchester County, and the Hudson Valley. Founded in 2009, True Care has expanded to meet the growing demand for affordable, quality care. With 15 True Care locations throughout the region, our diverse community of caregivers serve all clients with a common goal—providing outstanding home care experiences with dignity and respect. We empower our clients to remain at home with greater ease and safety. From our home health assistance and nursing care services to our comprehensive support services and caregiver certification programs, our work is an expression of our deep commitment to each client and every family we serve. True Care is accredited by The Joint Commission, meeting the industry’s highest nationally recognized standards of care.

Frequently Asked Questions

In most cases, yes. Home care recipients are typically receiving care because of age or a qualifying medical condition, both of which fall under the exemption categories. If you’re a True Care client, this requirement most likely does not apply to you. And if it turns out you’re not exempt, our team is here to help you figure out the next steps, just contact us.

Yes. Adults 65 and older are exempt from the work requirement entirely, regardless of employment status.

Yes, if you’re the parent, guardian, or primary caregiver for a disabled family member or a child under 14. The exact rules depend on your situation, so contact us and we’ll confirm where you stand.

Being enrolled in Medicaid on the basis of a disability, or having a health condition that makes working difficult, generally qualifies you for an exemption. Documentation requirements can vary, so it’s worth confirming ahead of your next renewal.

You may need to show proof of your exemption when you apply or renew, so it’s not always automatic. New York State will generally indicate what’s needed in your renewal notice, and our care coordinators can help you gather the right documentation.

You could lose Medicaid coverage. If you think this might apply to you and you’re not sure how to meet the 80-hour requirement, reach out to us or to New York State of Health as early as possible. There are often more options than people expect.

The work requirement is one of several changes happening around the same time, including renewal timelines and retroactive coverage. See our complete guide to the 2027 Medicaid changes for the full picture.

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