Medicaid Unwinding: What Medicaid Recipients Need to Know
At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a provision that Medicaid programs keep people continuously enrolled through the end of the COVID-19 public health emergency (PHE). The PHE ended on May 11, 2023, as well as continuous enrollment in Medicaid coverage. Starting April 1, 2023, your state Medicaid office began the process of redetermining your eligibility for health coverage under Medicaid. Please note, Medicaid has state-by-state qualifications. Please check your state’s Medicaid requirements at https://www.medicaid.gov/. Here are some things you need to know to help keep your Medicaid coverage as well as the options you have if you lose coverage.
Tips for Insuring Patients Maintain Coverage
- Make sure your state Medicaid agency has your current address and contact info. If your current contact information is not on record with your state Medicaid agency, then your renewal may be delayed and/or denied.
- Be on the look out for renewal forms in the mail or via email.
- Complete renewal forms and return them in a timely manner.
Note: each state has different timelines that you need to have returned your renewal. Some are as short as 30 days!
- Find local advocates to support you, if needed, such as your local Center for Independent Living (CIL), or navigators.
If you lose coverage, don’t panic. Contact your local Medicaid agency to find out if there was a procedural reason your Medicaid was terminated. This could be due to an incomplete application, not enough information on income, or you did not provide the additional information requested by your state agency. There is a possibility that procedural reasons can be corrected. You also have the right to file an appeal of your termination. Please check with your Medicaid agency to find the appeal timeline for your state. Since Medicaid enrollment is year round, you may be able to immediately reapply, although some states do have a waiting period.
If you are no longer eligible, you are automatically eligible for a special enrollment period on the ACA marketplace within 60 days from determination. Contact your local CIL, or other local resources for assistance. You can also go to healthcare.gov and select “Find Local Help” to find local assistance resources.
Below are some helpful resources:
- You can learn more at Medicaid.gov or by searching #StayCovered on social media.
- FACT SHEET: End of the Medicaid Continuous Coverage Requirement – What People with Disabilities Need to Know from the American Association on Health & Disability
- English and Spanish language resources on the CMS website.
- For the state of Ohio, you have 90 days to respond to renewal forms: Members should still send in their renewal packets even if the due date has passed. Eligible members whose coverage has been discontinued for failing to respond, have 90 days to reenroll in Medicaid without needing to submit a new application.