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What You Need to Know About Continuous Enrollment if You Have Medicaid

Do you have Medicaid? If you do, then you need to understand if the end of Medicaid continuous enrollment will affect you. This blog provides an overview of Medicaid continuous enrollment, what has changed, and what this means for people who have Medicaid.

What is Medicaid continuous enrollment?

As of September 2022, more than 90 million people were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). These are government-sponsored health insurance programs for individuals with low incomes and/or low assets.

Since 2020, because of the COVID-19 public health emergency, Medicaid has allowed continuous enrollment, meaning that people have not been required to recertify their eligibility. They also have not been disenrolled, even if they are no longer eligible for coverage under current Medicaid guidelines (e.g., if their income and/or assets increased over the past two years). This period of time has been referred to as Medicaid Continuous Enrollment.

What has changed?

At the end of December 2022, the Consolidated Appropriations Act, 2023, was enacted. Among other things, this legislation ends Medicaid Continuous Enrollment on March 31, 2023.

As of April 1, 2023, state Medicaid programs can begin to disenroll people who are no longer eligible for Medicaid. The disenrollment process is expected to take at least a year. Some states have already started to figure out if people are eligible to have their Medicaid renewed, but the earliest date a state can terminate someone’s eligibility is April 1.

What does this mean for people who have Medicaid?

If you or someone you know is enrolled in Medicaid, there are steps you can take now to prepare:

  • Read and respond to your mail. Your state Medicaid office may need additional information from you to be able to decide whether you are still eligible for coverage. It’s important for them to have your current contact information. If you moved, or changed your phone number or email address, you can find out how to contact your state’s office to let them know your new information by visiting Medicaid.gov, scrolling to the bottom of the page, and selecting your state from the map. Not everyone will receive a renewal form from Medicaid; if you do receive one, complete it and return it.
  • Understand your options. Just because you receive a request for updated information from your state Medicaid office does not mean you won’t be able to keep getting Medicaid coverage. But, if you are no longer eligible for Medicaid, you may have other options for health insurance coverage. You can explore these options now, so you are prepared in case you lose your Medicaid coverage at some point in the future.

What other health insurance options might I have?

  • Check whether you are eligible for employer-sponsored coverage through your job, or, if applicable, through a spouse’s or parent’s job. Contact the employer’s human resources department to get details about when and how you can enroll in the employer’s health plan. Plans often have special enrollment periods for people who have lost other coverage.
  • Consider your state’s Health Insurance Marketplace. There is a Marketplace Special Enrollment Period for people who lose or are denied Medicaid/CHIP coverage because they are no longer eligible. This Special Enrollment Period can be used if you lost coverage in the past 60 days or expect to lose coverage within the next 60 days.
  • Depending on the size of your household and your household income, you may be eligible for financial assistance to help pay for your Marketplace insurance. According to the Centers for Medicare & Medicaid, four out of five customers should be able to find plans for $10 or less per month after tax credits.
  • To get started searching for Marketplace plans, visit HealthCare.gov. Need help with the Marketplace? There are local assisters who are trained, certified, and required to provide fair, impartial, and accurate information.
  • When shopping for health insurance, there are a number of factors to consider, including costs, networks of health care providers, and prescription drug coverage. Triage Cancer can help! We have resources about Picking a Health Insurance Plan, including our Health Insurance Plan Comparison Worksheet and an animated video.

Can I appeal if my Medicaid coverage ends?

If you are told you will be your Medicaid coverage will end, and you believe this is a mistake (e.g., Medicaid has incorrect information about your income and/or assets), you have the right to appeal. The appeals process depends on where you live, but generally, you must file an appeal within 90 days of receiving a Notice of Action (NOA). Read any instructions you receive about appeals carefully and pay close attention to deadlines. Contact the Medicaid Office where you live with questions.

For more information about Medicaid, visit TriageCancer.org/Medicaid. For more information about health insurance options, visit TriageCancer.org/HealthInsurance.

About Triage Cancer

Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through eventsmaterials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.

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