Coverage Options When Medicaid Renewal Begins

Learn what Medicaid renewal is and how it could impact your health coverage. We’re here to help you stay covered.

 

Need help? Answer a few quick questions to learn which benefits you may qualify for today, including health insurance and other benefits like food and transportation.

Enrolled in a Medicaid, CHIP, or Expansion plan and want to prepare for renewal? Keep your address updated with your state agency and watch for your renewal packet by mail.

If you lose Medicaid coverage, you are eligible for a special enrollment period. You typically have 60 days to find a new health plan from the time you lose Medicaid.1

Earn too much to qualify for Medicaid? You may qualify for an Individual Marketplace plan.

What You Need To Know

During the Public Health Emergency (PHE), nearly all Medicaid, Children's Health Insurance Program (CHIP), and Expansion members kept their coverage, regardless of changes in eligibility or status. Legislation signed on December 29, 2022, allows states to begin removing ineligible members from their Medicaid programs starting April 1, 2023.

 

You May Lose Coverage If You No Longer Qualify For Medicaid

 

When yearly Medicaid renewals start again, millions of individuals will need to take action to keep their current Medicaid coverage or, if they no longer qualify, find a new health plan that’s right for them. We can help you with your options, should you lose coverage.

Frequently Asked Questions About Medicaid Renewal

What Is The Public Health Emergency Or PHE?

 

As a result of the COVID-19 pandemic, a Public Health Emergency (PHE) was put into place by the federal government on January 27, 2020. Prior federal law addressing the COVID-19 pandemic paused yearly state Medicaid renewals.

What Is Medicaid Renewal?

Medicaid renewal is a yearly review completed by your state to check if you’re still eligible for your coverage. In most states, you have to renew your coverage every year to keep it. Missing the deadline, not completing paperwork, or forgetting a step in the renewal process all put you at risk of losing Medicaid coverage.

If you’ve had a change in income, age, or other qualifying factors since you enrolled in Medicaid, it’s possible you will no longer qualify. The only way to know for sure is to renew on time.

When it’s time for you to renew, you’ll get a notice telling you what to do. Be sure to follow the steps to renew quickly. If you have questions, call the Member Services number on your insurance ID card.

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What Can People Do Now To Prepare For Their Medicaid Renewal?

Check if your state agency has your current mailing address and contact information. If you’ve moved or your contact information has changed, contact your state now. Important updates about your coverage come through the mail, including a notice when it’s time for you to renew. If your contact information isn’t up to date with your state agency, you may miss these notices.

Understand your health coverage options. If you’ve had major changes in your income, or household, it’s a good idea to explore other health plans now in case you no longer qualify for Medicaid coverage. You may even be eligible for a free or low-cost Individual and Family Marketplace plan.2

 

Check what health coverage you may qualify for, including health insurance and other benefits like food and transportation.

If I Am Working, Can I Get Health Coverage Through My Job?

 

If you lose Medicaid, but are working, you may have access to health coverage through your job. You typically have 60 days from the date you lose Medicaid to enroll in coverage through your job. Ask your employer what your options are.

 

However, if you or your family members are not covered under a health plan offered through your job, Individual and Family Marketplace insurance plans may be an option. With the new IRS rule to make health coverage more affordable, you and your family members may now be eligible to receive financial help on a Marketplace insurance plan.

How Can I Find Affordable Health Coverage If I No Longer Qualify For Medicaid?

We can help connect you to a plan that’s right for you. If you can’t get health insurance through your job and you’re under age 65, an Individual and Family plan through the Health Insurance Marketplace may be right for you.

How Much Does Marketplace Health Insurance Cost?

Individual and Family Marketplace health insurance plans are available to anyone who does not have health insurance, including those no longer eligible for Medicaid coverage. Marketplace plans are available in Bronze, Silver, and Gold metal levels and offer benefits like doctor visits, prescriptions, hospital care, and mental health care. You also may be eligible for financial help (a subsidy) that could lower your premium (monthly payment) - or even reduce it to $0 a month.2

When Can I Enroll In Marketplace Health Insurance After Losing Medicaid Coverage?

Open Enrollment for Marketplace plans runs every year from November 1 through January 15, in most states. If you no longer qualify for Medicaid coverage, you are eligible for a special enrollment period. You typically have 60 days to apply for a Marketplace insurance plan or to enroll in coverage through your job, from the date you lose Medicaid.1

What Are Cost-Sharing Reductions?

Along with a subsidy that can lower your monthly premium, cost-sharing reductions (CSRs) are extra savings that can reduce your out-of-pocket costs when you get medical care. If your income is within the range that qualifies you for a CSR, you must enroll in a plan in the Silver tier to receive the extra savings.

How Do I Enroll In A Marketplace Insurance Plan?

Visit healthcare.gov to find a Marketplace health plan that fits your specific needs and budget. This will help ensure you don’t have a gap in health coverage for you and your family.

When Can I Enroll In Marketplace Health Insurance After Losing Medicaid Coverage?

Open Enrollment to enroll in an Individual and Family Marketplace insurance plan runs every year from November 1 through January 15, in most states. If you no longer qualify for Medicaid coverage, you are eligible for a special enrollment period. You typically have 60 days to apply for a Marketplace insurance plan or to enroll in coverage through your job, from the date you lose Medicaid.1

Are There Marketplace Insurance Plan Options with $0 Monthly Premiums?

Yes. While you may earn too much to remain eligible for Medicaid coverage, you may qualify for an Individual and Family Marketplace insurance plan that has a monthly premium payment as low as $0 (after subsidy applied).2

What Are Cost-Sharing Reductions?

Along with a subsidy that can lower your monthly premium, cost-sharing reductions (CSRs) are extra savings that can reduce your out-of-pocket costs when you get medical care. If your income is within the range that qualifies you for a CSR, you must enroll in a plan in the Silver tier to receive the extra savings.

How Do I Enroll In A Marketplace Insurance Plan?

You can enroll online, or we can help guide you through the application process to find an Individual and Family Marketplace insurance plan that fits your specific needs and budget.

You Can Feel Confident That You Have Health Insurance Options

You have other healthcare plan options if you lose Medicaid coverage. We can help you make the transition and find a plan that fits your needs and your budget.

Explore Your Options

Understand Your Coverage Options

Medicaid Plans

If you need information about Medicaid, call the number on the back of our ID card.

Individual & Family Marketplace Insurance Plans

If you are under 65, find low-cost health plans for you and your family.

Medicare Plans

If you’re 65 or older, find information about Medicare health plans.

Plans Available Through Your Job

If you’re working, ask your employer about your health plan options. If you or your family are not covered under a health plan through work, explore Individual & Family plan options.

If you are an employer, a producer, or healthcare provider, click below for more information.

For Producers 

For Employers 

For Providers 

Additional Information

Stay informed by checking these useful resources for additional information on Medicaid renewals and more.

1 Guidance may be issued at a later date extending the special enrollment period in some circumstances.

 

2 Based on federal and/or state exchange requirements and subject to change. Anthem Blue Cross and Blue Shield and HealthKeepers, Inc. are Qualified Health Plan issuers that in certain geographic areas offers some health plans with a $0 or $1 premium option (after subsidy applied) through the Health Insurance Marketplace or your State Exchange. Health plans with a $0 or $1 premium option are not available in all areas and eligibility for these plans is based on federal annual income guidelines. Call us for information because not everyone will qualify. For example, singles earning up to $19,140, and couples earning up to $25,860 may be eligible. Family income eligibility varies based on number of family members.

 

This marketing material is not yet approved in all states.

 

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