During the pandemic, state Medicaid programs were required to keep beneficiaries enrolled, even if they did not meet the eligibility criteria. This requirement will expire on May 11, 2023. With the Public Health Emergency ending, states can resume Medicaid disenrollment starting April 1 – leaving individuals without health coverage. The OIF urges you to contact your state Medicaid agency providers to retain coverage or if no longer eligible switch to other sources of coverage.
The Medicaid and CHIP Communications Toolkit suggests taking the following steps to stay enrolled:
- Update your contact information – Make sure your state’s Medicaid or CHIP program has your current mailing address, phone number, email, or other contact information. This way, they’ll be able to contact you about your Medicaid or CHIP coverage.
- Check your mail – Your state’s Medicaid or CHIP program will mail you a letter about your Medicaid or CHIP coverage. This letter will also let you know if you need to complete a renewal form to see if you still qualify for Medicaid or CHIP.
- Complete your renewal form (if you get one) – Fill out the form and return it to your state’s Medicaid or CHIP program right away to help avoid a gap in your Medicaid or CHIP coverage.
Other important messages:
- If you no longer qualify for Medicaid or CHIP, you may be able to get health coverage through the Health Insurance Marketplace®. Marketplace plans are:
» Affordable. 4 out of 5 enrollees can find plans that cost less than $10 a month.
» Comprehensive. All plans cover things like prescription drugs, doctor visits, urgent care, hospital visits, and more.
- Losing Medicaid or CHIP coverage is a Qualifying Life Event (QLE), which allows you to enroll in a Marketplace plan outside of the Open Enrollment Period.
- Visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to get details about Marketplace coverage.
- If your child no longer qualifies for Medicaid, you may be able to get them health coverage through your state’s Children Health Insurance Program (CHIP).
- For more information about Medicaid renewal or CHIP coverage, contact your state Medicaid office or visit Medicaid.gov.
For more information, please consult: Medicaid.gov/Renewals
For those who will not be covered through Medicaid, please find information on Federally-Facilitated Marketplace (FFM) coverage below:
Federally-Facilitated Marketplace (FFM): Overview of Key FFM Processes and Updates on Plans for Medicaid Unwinding
Medicaid Unwinding Special Enrollment Period (SEP)
- To ensure individuals have sufficient time to enroll in Marketplace coverage during the unwinding period, consumers who lose Medicaid/CHIP coverage between March 31, 2023 and July 31, 2024 will be eligible for a 60-day SEP beginning the day they submit or update a Marketplace application.
- Consumers can access this Unwinding SEP by submitting or updating an application through HealthCare.gov, a certified partner that supports SEPs, or the Marketplace Call Center.
- CMS has published Marketplace guidance on the unwinding SEP: https://www.cms.gov/technical-assistance-resources/temp-sep-unwinding-faq.pdf
- CMS recommends that Medicaid/CHIP enrollees submit or update an application on HealthCare.gov as soon as they receive their Medicaid/CHIP termination letter from their state.
More information can be found at: https://www.healthcare.gov/medicaid-chip/transfer-to-marketplace/