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Nevada Medicaid Work Requirements Exemptions: Your 2027 Checklist

Last verified: September 29, 2026

Starting January 1, 2027, many Nevada Medicaid adults ages 19 to 64 must show 80 hours a month of work, school, or volunteering — unless an exemption applies. Under the federal rule, exempt groups include parents and caregivers of a child 13 or younger, people who are medically frail, pregnant or postpartum people, and people on Medicare. Nevada Medicaid decides.

Raising a toddler, caring for a relative with a disability, or getting addiction treatment? This checklist of Nevada Medicaid work requirements exemptions can help you see which groups may fit your life.

You may not have to meet the 80-hour rule at all. In April 2026, the Nevada Health Authority told state lawmakers that about 270,000 Nevadans are in the Medicaid expansion group. About 147,000 are likely subject to the rule.

We could not verify Nevada's own list of exemptions, so this checklist uses the federal rule, which Nevada must follow. Check with Nevada Medicaid about your case.

New to the rule? Start with our Nevada Medicaid work requirements guide.

Who is exempt from Medicaid work requirements? The checklist

Under the federal rule, if one of these fits you for all or part of a month, you're treated as meeting the rule for that month.

Family and caregiving

  • Parent or caregiver of a young child: You're a parent, guardian, caretaker relative, or family caregiver of a dependent child 13 or younger (under 14).
  • Caregiver of a person with a disability: You're a parent, guardian, caretaker relative, or family caregiver of a person with a disability.

Who counts as a family caregiver?

Under the federal rule, a family caregiver is someone who lives with the child or person with a disability. It can also be a relative who gives them regular "non-incidental" help, or someone who gives them at least 80 hours of help a month. Any one of these is enough.

Health and treatment

  • Medically frail: You have a condition that significantly impairs your ability to meet the rule. See the details below.
  • In treatment: You're taking part in a drug addiction or alcohol treatment and rehabilitation program.

Other benefit programs: TANF (NEON) and SNAP

  • TANF: You're meeting TANF work requirements. In Nevada, TANF's employment program is NEON (New Employees of Nevada).
  • SNAP: You're in a household that gets SNAP, and you're subject to SNAP work rules (not exempt from them).

Age and Medicare

  • Under 19, or 65 and older: You're outside the 19-to-64 age range the rule covers.
  • Medicare: You're entitled to or enrolled in Medicare Part A or Part B.

Other groups

  • Former foster youth: You're under 26 and get Medicaid through the former foster care group.
  • American Indian or Alaska Native: You meet the federal definition.
  • Veteran with a 100% VA rating: Your VA disability rating is total (100%), temporary or permanent.
  • Pregnant or postpartum: You're pregnant or entitled to postpartum coverage.
  • In jail or prison, now or recently: You're an inmate of a public institution, such as a jail or prison, or you were at any time in the 3 months before that month.
  • Another Medicaid group: You're covered through certain mandatory Medicaid groups, not the adult expansion group. Not sure? Ask Nevada Medicaid.

What "medically frail" means for Medicaid

Under the federal rule, you may be medically frail if a condition "significantly impairs" your ability to meet the rule. The condition must also fit one of these five types:

  1. Blind or disabled, under Social Security's definition
  2. A substance use disorder, unless you've been in stable recovery for 5+ years
  3. A disabling mental disorder
  4. A physical, intellectual, or developmental disability that significantly impairs one or more activities of daily living
  5. A serious or complex medical condition

Nevada Medicaid told lawmakers in April 2026 that members could self-declare medical frailty and the state would audit it. We could not verify Nevada's final process.

Under the federal rule, states must re-check medically frail status at least every 12 months.

Short-term hardship: ask Nevada Medicaid

The federal rule lets states offer short-term hardship exceptions. They're optional, and we could not verify which ones, if any, Nevada adopted. If a state offers them, they work like this:

Your situationUnder the federal rule
You get inpatient hospital, nursing facility, ICF/IID, or inpatient psychiatric careYou must ask for it
You live in a county with a federal disaster declaration or high unemploymentThe state applies it on its own
You travel for an extended time outside your community for serious or complex care not available locally, for yourself or a dependentYou must ask for it

Ask Nevada Medicaid whether any of these applies to you.

How to tell Nevada you may be exempt

  1. Watch for your letter. Nevada began mailing about 250,000 letters in September 2026, followed by texts and emails. According to the Nevada Health Authority, as reported by Nevada Current, these notices explain who is affected, what counts, how to report, and how to ask for an exemption. See what to do after you get the letter.
  2. Expect a data check first. Nevada Medicaid told lawmakers it planned to check data it already has, such as state wage and education records.
  3. Answer the screening form carefully. Nevada also planned a screening form where members attest they meet the rule. It said those answers "will be audited."
  4. Keep proof. Save copies of anything that shows why you may be exempt, like your child's birth certificate or papers showing your VA disability rating.
  5. Keep your contact info current. Update it through Access Nevada, the bilingual paper change form, or a local office of the Division of Social Services (formerly DWSS).
  6. Know your renewal date. It's in the NVMedicaid app under "My Benefits." Under the federal rule, states check at application and renewal, and may check more often.

Nevada has not published a reporting portal that we could verify. Follow the instructions in your letter and on Nevada Medicaid's official page: Nevada Medicaid: Work, School, and Volunteer Requirements.

If Nevada can't confirm, you get 30 days

Under the federal rule, if the state can't verify that you meet the rule, it sends a notice. You then have 30 calendar days to show you meet it or that an exemption applies, and your coverage continues during that time. Learn what happens if you don't meet the requirement.

Not exempt? Here's how to meet the 80 hours

If no exemption fits, the federal rule offers these ways to qualify each month:

  • 80 hours of work
  • 80 hours of community service in a structured program run by a public or nonprofit group that tracks your activity, dates, and hours
  • 80 hours in a work program like WIOA or SNAP Employment and Training (job search alone doesn't count)
  • Being enrolled in school at least half-time
  • A mix of work, community service, work programs, and school that adds up to 80 hours
  • Income of at least $580 a month (the $7.25 federal minimum wage × 80 hours)
  • For seasonal workers, average income of at least $580 a month over the past 6 months

See free ways to meet the 80 hours in Las Vegas, from job training to volunteering. Nevada Medicaid decides what counts.

Help near you in Southern Nevada

Want help going through this checklist? Call or text 725-214-1433 (TTY 711).

Southern Nevada Health Pass is at 5450 W Sahara Ave Ste. 320, Las Vegas, NV 89146, inside the 5450 West Sahara Community Resource Center. Services at the center include veterans benefits navigation, reentry support, ID and records help, and case management.

Find more local help in Southern Nevada, or get a free benefits check to see what your health plan already includes.

Get free email alerts from Southern Nevada Health Pass when Nevada shares new details about exemptions or how to report them.

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.

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We never ask for your Social Security number or Medicaid ID.

Frequently asked questions

Am I exempt if I take care of my mom?

You may be, if your mom has a disability. Under the federal rule, a family caregiver of a person with a disability is exempt. You count as a family caregiver if you live with her, give her regular non-incidental help as a relative, or give her at least 80 hours of help a month. Nevada Medicaid decides.

Does having a child under 14 exempt me?

It may. Under the federal rule, a parent, guardian, caretaker relative, or family caregiver of a dependent child 13 or younger is exempt. CMS describes this as a parent or guardian of "a child under 14." This reason ends once your youngest child turns 14, so check the other groups too. Nevada Medicaid decides.

I'm in treatment for addiction — do I still have to report hours?

You may not have to meet the 80 hours. The federal rule exempts people taking part in a drug addiction or alcohol treatment and rehabilitation program, and a substance use disorder may also count as medically frail. Follow your letter's instructions to tell Nevada about your situation. Nevada Medicaid decides.

Are people on unemployment exempt?

Not under the federal rule. Unemployment benefits are not on its list of exemptions. You may still be exempt for another reason on this checklist. If not, you can meet the requirement through work, school, volunteering, or a work program. Job searching alone doesn't count, but hours in a workforce program like WIOA can. Nevada Medicaid decides what counts.

Do I need a doctor's note to be medically frail?

Nevada Medicaid told lawmakers in April 2026 that members could self-declare medical frailty and the state would audit it. We could not verify Nevada's final process, so follow your letter. Keep records from your doctor or clinic in case you're asked. Under the federal rule, the state must re-check frailty at least every 12 months.

Not sure which group fits you? We can go through this checklist with you. Nevada Medicaid makes the final decision.

Call or text 725-214-1433 — free, English or Spanish. TTY 711. We never ask for your Social Security number.

Sources

Southern Nevada Health Pass is a free, independent benefits navigation service. We are not an insurance agency or broker, we do not sell insurance, and we are not paid by any health plan. We are not affiliated with or endorsed by Nevada Medicaid, the Nevada Health Authority, CMS, or any government agency. This page is general information, not legal advice. Nevada Medicaid makes all eligibility decisions.

Southern Nevada Health Pass is a free benefits navigation service. We are not an insurance agency or broker, we do not sell insurance, and we are not paid by any health plan. We are not affiliated with or endorsed by Nevada Medicaid, the Nevada Health Authority, CMS, or any government agency, and we do not decide your eligibility. For questions about your coverage, contact your health plan directly. For Medicare questions, call 1-800-MEDICARE (TTY 1-877-486-2048). To change your Nevada Medicaid plan, call (866) 569-1746 (TTY 7-1-1).

We are not part of, affiliated with, or endorsed by the Southern Nevada Health District (SNHD).

Call/Text 725-214-1433 · TTY 711.