Medicaid/CHIP Periodic Data Matching
Consumers who are eligible for Medicaid or the Children's Health Insurance Program (CHIP) are not eligible for advance premium tax credit (APTC) or cost-sharing reductions (CSRs) through the Exchange per regulation 26 CFR § 1.36B-2(a)(2). As described in regulation 45 CFR § 155.330(d)(1)(ii), Medicaid/CHIP Periodic Data Matching (PDM) is the process in which the Exchange periodically examines available data sources to determine whether consumers who are enrolled in Exchange coverage with APTC/CSRs are also enrolled in Medicaid or CHIP that counts as qualifying coverage, also known as minimum essential coverage (MEC). As described at 45 CFR § 155.330(e), the Exchange notifies these consumers they are not eligible for APTC/CSRs for their Exchange coverage premium and covered services if they are dually enrolled and should take action to end their APTC/CSRs or terminate their Exchange coverage. If consumers choose to remain enrolled in full-cost Exchange coverage, they should notify their state Medicaid agency (SMA) of their qualified health plan (QHP) enrollment through the Exchange, as they may no longer be eligible for CHIP. Please review the public files below to learn more.
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Medicaid/CHIP PDM Published Data
- 2025 Medicaid/CHIP PDM Expire by State (XLSX)
- 2026 Medicaid/CHIP PDM Expire by State, Round 1 (XLSX)
- 2026 Medicaid/CHIP PDM Expire by State, Round 2 (XLSX)
Medicaid/CHIP PDM FAQ
Medicaid/CHIP PDM Notices
- Medicaid and CHIP: Initial Notice (August 2026)
English (PDF) | Spanish (PDF) - Medicaid and CHIP: Resolution Notice (August 2026)
English (PDF) | Spanish (PDF) - Medicaid and CHIP: Final Notice (August 2026)
English (PDF) | Spanish (PDF)
Medicare Periodic Data Matching
Consumers could be “dually enrolled” in both Medicare and a QHP. The purpose of Medicare PDM is to identify these individuals and end their APTC/CSR or their QHP coverage, if the consumer provides written consent for the Exchange to end their QHP coverage on their behalf, so they are enrolled solely in Medicare coverage. Please review the public files below to learn more.
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Medicare PDM FAQ
Medicare PDM Notices
- Medicare Initial Notice (September 2023)
English (ZIP) | Spanish (ZIP) - Special Medicare Notice for Consumers Turning 65 (June 2023)
English (PDF) | Spanish (PDF)
- Medicare Initial Notice (September 2023)
Death Periodic Data Matching
Death PDM is the regular check of Exchange consumers who have filed single-member applications to verify they are not deceased. If consumers are deceased, the Exchange will notify their estates and end their coverage. Please review the public files below to learn more.
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Death PDM FAQ
Death PDM Notices
- Estate Initial Notice (September 2022)
English (PDF) | Spanish (PDF) - Estate Response Notice (September 2022)
English (PDF) | Spanish (PDF) - Estate Final Notice (September 2022)
English (PDF) | Spanish (PDF)
- Estate Initial Notice (September 2022)