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
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 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 benefits 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 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.
What Can People Do Now To Prepare For Their Medicaid Renewal?
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. 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 lose your Medicaid coverage. You may be eligible for a low-cost Marketplace health plan.
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, a Marketplace plan may be an option. With the new IRS rule to make health coverage more affordable, your family members may now be eligible to receive financial help on a Marketplace health plan.
How Can I Find Affordable Health Coverage If I No Longer Qualify For Medicaid?
If you can’t get health insurance through your job and you’re under age 65, an Individual plan through the Health Insurance Marketplace may be right for you.
How Much Does Marketplace Health Insurance Cost?
Marketplace health 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 the monthly amount you pay for a Marketplace health plan.
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
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.
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 Coverage Options
If you need information about Medicaid, call the number on the back of our ID card.
Individual Marketplace Plans
If you’re under 65, find low-cost health plans for you and your family.
Plans Available Through Your Job
If you’re working, ask your employer what your health plan options are. If you or your family are not covered under a health plan through work, explore Marketplace plan options.
If you are an employer, a producer, or healthcare provider, click below for more information.
Stay informed by checking these useful resources for additional information on Medicaid renewals and more.
Information On Testing And Vaccinations:
1 Guidance may be issued at a later date extending the special enrollment period in some circumstances.