Medicaid Work Requirements for Veterans
Only veterans with a total VA disability rating are exempt because they are veterans. Other veterans can still qualify for a different exemption, and VA job programs count toward the 80 hours.
Short answer: Veterans are exempt only if the VA rates their disability as total (100%), either temporary or permanent. CMS says veterans paid at the 100% rate through individual unemployability (TDIU) also qualify. Other veterans ages 19 to 64 in the adult expansion group must meet the 80-hour rule starting January 1, 2027 (earlier in a few states), unless another exemption fits.
The rule in the law
Federal law excludes a person "who is a veteran with a disability rated as total under section 1155 of title 38" (sec. 1902(xx)(9)(A)(ii)(IV)). The CMS rule says this means a temporary or permanent VA disability rated 100% (42 CFR 435.554(c)(4)).
In the rule's preamble, CMS adds that veterans who get total disability based on individual unemployability (TDIU), which pays at the 100% rate even when the combined rating is lower, must be treated the same as veterans rated 100%.
How often it is checked
- Permanent and total (P&T): once your state verifies it, it may not check again.
- Temporary 100%: rechecked at least every 12 months, but not more often than your renewal.
Veterans without a total rating
You may still be exempt another way, for example if you:
- Have a disability or serious health condition (see medically frail)
- Care for a child 13 or younger or a person with a disability (see parents and caregivers)
- Are in drug or alcohol treatment, get SNAP and are subject to its work rules, or have Medicare
If you need to meet the rule, VA and Department of Labor job and training programs for veterans count as a work program. The CMS rule says any Labor or VA employment and training program that serves veterans is an approved work program. Being enrolled in VA health care does not change the Medicaid rule.
What proof is usually needed
CMS said it is looking at a data match with the VA, but until a state has one, it must ask you for proof. Your VA benefit summary letter, which you can download from VA.gov, shows your rating and whether it is permanent and total. If you get TDIU, the letter shows that you are paid at the 100% rate.
What to do next
- Download your VA benefit summary letter and keep a copy.
- Use the free checker to see if the rule applies to you and which exemptions may fit.
- Not rated 100%? Count VA or job center training hours with the 80-hour calculator.
- Find your state guide for start dates, how to report, and who to call.
- Got a notice? You have at least 30 days to answer, and you can ask for a fair hearing. See what to do about a notice.
Frequently asked questions
Are veterans exempt from Medicaid work requirements?
Only veterans with a total (100%) VA disability rating, temporary or permanent, or TDIU. Other veterans must meet the rule unless another exemption fits.
I am rated 70% and get TDIU. Am I exempt?
Yes. CMS says veterans who get total disability based on individual unemployability are paid at the 100% rate and must be treated like veterans rated 100%.
Do VA job training programs count toward 80 hours?
Yes. Employment and training programs for veterans run by the Department of Labor or the VA count as a work program.
Does a VA pension exempt me?
Not by itself. The law names only a disability rated as total. A veteran on a pension may still be exempt for another reason, such as a disability or serious health condition.
Are veterans exempt from SNAP work rules too?
No. SNAP has different rules. The SNAP veteran exemption ended in 2025. See SNAP work rules for veterans.
Sources
- Public Law 119-21 (H.R. 1), sec. 71119: community engagement requirement (GovInfo)
- CMS interim final rule, Medicaid community engagement requirement, 91 FR 33348 (June 3, 2026)
- CMS-2454-IFC, official PDF (GovInfo)
- U.S. Department of Veterans Affairs: individual unemployability (TDIU)
- U.S. Department of Veterans Affairs: download your VA benefit letters