Nevada Medicaid Work Requirements: What You Need to Do Before Your 2027 Renewal

Starting January 1, 2027, many Nevada Medicaid members ages 19–64 in the Medicaid expansion group must show 80 hours a month of work, school, job training or volunteering — or at least $580 of income in a month — when they apply or renew. Some people are excluded.

Last verified: September 29, 2026, against Nevada Medicaid and federal guidance. Rules can change — we update this page when Nevada publishes new details.

Not sure if this applies to you? Call/Text 725-214-1433 and we'll walk through it with you. Free, no obligation.

The requirement

80 hours in a review month of qualifying activity, OR at least $580 of countable income in a review month.

Applying on or after January 1, 2027: you'll need to show one month before you apply. Renewing: you'll need to show at least one month before your renewal date. Nevada told lawmakers it planned to accept any one of the six months before your renewal.

Qualifying activities

Work: 80 hours in the month
School: enrolled at least half-time (fewer hours can be combined with other activities)
Job training or a work program, such as WIOA programs through EmployNV (job search alone does not count)
Community service: 80 hours of unpaid volunteering with a public agency or nonprofit that tracks your hours
Income: at least $580 in the month from a job or self-employment ($7.25 × 80 hours)
Seasonal work: average income of at least $580 a month over the past 6 months

You can combine activities. For example, 40 hours of work plus 40 hours of volunteering adds up to 80.

Who does NOT have to meet this

The state calls these Specified Excluded Individuals.

Parent, guardian, caretaker relative or family caregiver of a child 13 or younger
Parent, guardian or family caregiver of a person with a disability
Pregnant, or in your postpartum coverage period
Former foster youth under 26 in Medicaid's former-foster-care group
American Indian or Alaska Native
Veteran with a 100% (total) VA disability rating
Medically frail — for example, a disability, a serious or complex medical condition, a disabling mental health condition, or a substance use disorder that significantly limits your ability to work, volunteer or go to school
In a drug or alcohol treatment and rehabilitation program
Meeting TANF (NEON) work requirements, or in a SNAP household and not exempt from SNAP work rules
Currently incarcerated

Exceptions

Under 19
Entitled to or enrolled in Medicare
Incarcerated at any time in the three months before the review month
Met an excluded status in a lookback month

Short-term hardship (if Nevada offers it)

The federal rule lets states excuse a month for an inpatient hospital, nursing facility or psychiatric stay; extended travel for serious medical care not available locally; or living in a county with a disaster declaration or high unemployment. Ask Nevada Medicaid which of these it uses.

Renewals change to every 6 months

Some adults will renew every 6 months instead of every 12. This begins after your first renewal on or after January 1, 2027. You can see your renewal date in the NVMedicaid app under "My Benefits."

Get a free alert when Nevada updates the work rules

Nevada is still publishing details — like how to report your hours. We'll email you when something changes. Free. No spam.

New copays for some expansion enrollees

Starting October 2028, expansion adults with income above 100% of the federal poverty level may have copays of up to $35 per service. Primary care, mental health and substance use services, and care at federally qualified health centers, rural health clinics and certified community behavioral health clinics are exempt. Total out-of-pocket costs are capped at 5% of family income. Nevada is still waiting on federal guidance.

Frequently asked questions

Do I have to do anything right now?

Yes — get ready now. Update your address, phone and email so you don't miss letters (through Access Nevada, the change form, or a local Social Services office). Check your renewal date in the NVMedicaid app. Then check whether you're excluded, and if not, start keeping a log of your hours.

What if I work some months and not others?

The requirement is measured by review month: 80 hours of qualifying activity in a review month, or at least $580 of countable income in a review month. Seasonal work counts if it averages $580 a month over a six-month season.

Does volunteering count?

Yes, if it's unpaid community service with a public agency or nonprofit that tracks your hours. You can combine it with work or other activities to reach 80 hours.

I'm caring for my mom — am I excluded?

Possibly. Under the federal rule, a family caregiver of a person with a disability is excluded — for example, if you live with her, if you're a relative who gives regular help, or if you give at least 80 hours of care a month. Nevada Medicaid decides. Call or text 725-214-1433 and we'll help you check.

What happens if I don't meet the requirement?

Under the federal rule, if Nevada can't confirm you met it, you'll get a notice and 30 days to show you met it or that you're excluded. Your coverage continues during those 30 days. After that, Nevada may deny or end coverage with a written notice and the right to a fair hearing, and you can reapply at any time.

Where do I report my hours?

Nevada began mailing letters in September 2026. According to the Nevada Health Authority, they explain how to report. Nevada has said it will check records it already has, like wage and school data, and use a short form where you confirm you meet the rule. Follow your letter and keep your own log of hours. Want a heads-up when Nevada publishes more? Sign up for a free alert on this page.

Guides for your next step

Official state pages

Next step: free benefit activation help.