Are Your Medicaid Benefits Expiring?

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During the COVID-19 public health emergency, Congress passed the Families First Coronavirus Response Act (FFCRA) to prevent people from losing their Medicaid coverage. Normally, Medicaid beneficiaries must renew their coverage every 12 months; however, the FFCRA implemented a policy of continual enrollment. By extending continuous enrollment, the number of people enrolled in Medicaid increased by 29.8 percent from February 2020 to December 2022.

Now that Congress is rolling back provisions for the pandemic, the Consolidated Appropriations Act aims to end this continuous enrollment period as of March 31, 2023. As a result of this change, the ASPE (Assistant Secretary for Planning and Evaluation) estimates that 17.4 percent of people currently enrolled in Medicaid and Children’s Health Insurance Programs (CHIP) will lose their coverage.

While you may be concerned about your Medicaid coverage status, there are ways to check your status and keep your coverage in accordance with the all-important state and federal eligibility requirements that determine whether you will keep your plan after March.

FYI: While the names sound similar, Medicare and Medicaid are two entirely separate programs. To learn how each program functions and if you’d qualify for both, read our guide to the differences between Medicare and Medicaid.

Why People May Lose Coverage

Although Medicaid qualifications vary slightly by state, the predominant determinant of eligibility is a person’s income. If a person’s Modified Adjusted Gross Income exceeds a certain level, they will no longer be eligible for Medicaid coverage.

Those who lose their coverage but then reenroll within a short time, or “churn,” risk having gaps in their health coverage, sometimes as long as a year. Churn also increases Medicaid’s administrative costs through the process of reassessing each person’s eligibility. These costs could eventually trickle down to the beneficiaries.

The FFCRA program used its continuous enrollment provision to eliminate churn during the pandemic so that no one would have coverage gaps, whereas before the pandemic over one in 10 Medicaid beneficiaries had a gap of some length. With the continuous enrollment provision no longer in place, many full-benefit beneficiaries stand to lose coverage due to state-level reassessments of each person’s eligibility.

The Process Will Vary by State

Since Medicaid is a joint program between federal and state governments, each state has its own requirements for eligibility and enrollment. States are required to outline their unique approach to reassessing eligibility, but many follow a similar pattern.

First, all states are currently making progress in communicating with enrollees to update their contact information. Additionally, 74 percent of states reported that they would follow up with Medicaid beneficiaries about their eligibility before terminating their health coverage.

At the time of this writing, all states except New Mexico, West Virginia, and Wyoming, have posted several key documents to help beneficiaries renew or reassess their coverage. These include a public state plan, a contact information update, an FAQ, and a toolkit detailing the transition process.

As continuous enrollment unwinds, states will begin posting their public data dashboards to further aid the transition (23 are already up).

Who Is Losing Medicaid Coverage?

The main segment of beneficiaries who will lose Medicaid coverage consists of those who now make too much money to qualify for Medicaid. However, marital status and pregnancy status could also impact eligibility.

Since every state has different eligibility requirements, relocating during the pandemic could also impact your coverage, as you may not meet a new state’s Medicaid eligibility criteria.

HSS predicts that 45 percent of those who lose coverage will still be eligible for Medicaid; however, these people will simply be unable to renew their plans in time due to unfinished paperwork, an unreported address change, or confusion about how to renew their plans in a new system.

Importantly, not all states will disenroll beneficiaries as early as April, but those that will include Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma, and West Virginia.

How to Maintain Your Medicaid Coverage

You can maintain your Medicaid coverage even as states unwind the continuous enrollment provision by being vigilant about your status. Check your mailbox and online Medicaid account to confirm your eligibility, or consider Medicaid alternatives like ACA if you no longer qualify.

Check Your Mailbox

Medicaid will reach out to inform you that you need to renew your coverage. You should check your mailbox every day for their paperwork so that you don’t miss your state’s reenrollment period.

Also, make sure Medicaid has your updated contact information so they know how to reach you at your current address.

Check Your Medicaid Status

Medicaid offers an online tool to help you check your plan status. You can find it on their website here.

This tool offers resources for Medicaid beneficiaries in each state, including how to check your current status or plan eligibility. You can also find the contact information for your state’s Medicaid office there if you need more help discussing your status.

Consider ACA

If you no longer qualify for Medicaid, you should look into the Affordable Care Act (ACA) marketplace as an alternative. Also known as “Obamacare,” ACA coverage can offer health insurance coverage to low-income households or those who are otherwise ineligible for Medicaid.

Note that you only have 60 days from the end of your enrollment to register for a new plan. Otherwise, you will have to wait until the yearly Open Enrollment Period.

Bottom Line

With the Medicaid continuous enrollment provision ending, many current beneficiaries stand to lose coverage in 2023. Keeping your contact information updated is the best way to prevent your coverage from lapsing if you still qualify. However, not everyone will be able to meet their state’s eligibility requirements following the pandemic.

If that happens to you, consider ACA as an alternative to Medicaid coverage. Speak with your state office to learn more about your options following the end of continuous enrollment.

To learn more about Medicaid and Medicare, read our helpful guides:

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