Coverage Options After COVID-19 Public Health Emergency (PHE)

 

 

Learn what the COVID-19 Public Health Emergency (PHE) is and how it could impact your Medicaid health coverage when it ends. We’re here to help connect you with the information you need to stay covered.

What You Need To Know

During the COVID-19 PHE, all Medicaid and Children Health Insurance Plans (CHIP) members kept their coverage, regardless of changes in eligibility or status. When the PHE ends, millions of individuals may lose Medicaid and will have to take additional steps to keep their current coverage or find a new plan.  We are here to help you understand your health coverage options, should you lose coverage.

Frequently Asked Questions About Coverage And The PHE

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 on January 27, 2020. Federal law addressing the COVID-19 pandemic paused the yearly state Medicaid eligibility reviews due to unemployment and an urgent need for health coverage. During this time, all Medicaid and CHIP members kept their coverage, regardless of changes in eligibility or status.

How Does The PHE Impact Medicaid Renewals?

Before the PHE, states reviewed Medicaid eligibility annually. If the state found that someone no longer qualified for Medicaid coverage because of a change in income, age, or other factors, the state would disenroll them.

Medicaid renewals have been put on hold during the PHE, allowing many Medicaid beneficiaries to continue their coverage without a yearly review. When the PHE ends, Medicaid renewals will resume. As a result, some people may lose their Medicaid coverage.

Following the end of the PHE, people on Medicaid will need to complete a renewal with their state to see if they are still eligible for Medicaid. If you find out you no longer qualify for Medicaid, don’t worry. We can help you maintain coverage when the PHE ends, whether through an Individual Marketplace plan, Medicare, or your employer.

What Is Medicaid Renewal?

Medicaid renewal is a yearly review completed by your state to check if you’re still eligible for your coverage. You have to renew your Medicaid coverage every year to keep it. Missing your renewal deadline, incomplete paperwork, or forgetting a step in the renewal process all put you at risk of losing coverage.

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

When it’s time for you to renew, you will receive a notice from the state telling you what you need to do. Please follow the steps to renew quickly. If you have questions, call your Member Services number on your ID card.

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

To prepare for Medicaid renewal, the first thing you can do is check if your state has your current mailing address and contact information. If you’ve moved or your contact information has changed, contact your state now to update them. This way, you won’t miss any important notices about your health coverage or your renewal packet when it’s time to renew.

However, if you’ve had major changes to your income, employment, or household, you might want to start looking into what your other coverage options are. You can check your eligibility for other coverage or estimate your costs if you buy through the Marketplace. Enter your best guess of what your income will be in 2023.

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

 

If, after going through the renewal process, you no longer qualify for Medicaid coverage, but are currently employed, you may have access to health coverage through your company. Contact your employer to explore your options.

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

If you no longer qualify for Medicaid coverage, there are other options. If you do not have access to health coverage through your work, and are under age 65, you may want to consider an Individual & Family health plan through the Health Insurance Marketplace.

How Much Does Marketplace Health Insurance Cost?

Marketplace health plans are available to anyone who does not have health insurance, including individuals no longer eligible for Medicaid coverage. These plans offer comprehensive coverage that cover the 10 essential health coverage, including doctors’ services, hospital care, prescription drug coverage, and mental health services. You also may be eligible for financial help (a subsidy) that could significantly lower or completely eliminate the monthly amount you pay for a Marketplace health plan.

What Are Cost-Sharing Reductions?

In addition to a subsidy, cost-sharing reductions (CSRs) are extra savings that reduce your out-of-pocket costs by lowering your deductible, coinsurance or copays, and your out-of-pocket maximum. If your income qualifies you for CSRs, you must enroll in a plan in the Silver tier to receive the extra savings.

When Can I Enroll In An Individual Health Plan After Losing Medicaid Coverage?

If you no longer qualify for Medicaid coverage, you are eligible for a special enrollment period. You typically have 60 days from the date you lose Medicaid to apply for a Marketplace health plan, or 30 days from the date you lose Medicaid to enroll in employer-sponsored coverage.

How Do I Apply For A New 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.

You Can Feel Confident That You Have Health Insurance Options

 

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

Understand Your Options

Medicaid Plans

 

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

Individual & Family Plans

 

If you’re no longer eligible for Medicaid and need new health coverage, find information on Individual and family health plans.

Medicare Plans

 

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

Plans Available Through Your Work

 

If you’re employed, ask your employer what health plans are available to you.

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.