What You Need To Know About The Medicaid Unwinding
The eligibility of Medicaid members is being reviewed on a case-by-case basis.
Due to the COVID-19 pandemic, the federal government declared a Public Health Emergency (PHE). This permitted people with a Medicaid plan to continue to be covered even if they were no longer eligible to receive it. This means that for the past three years, Medicaid members did not have to complete an annual review.
On December 2022, Congress announced the ending of the Public Health Emergency and Medicaid’s continuous enrollment policy on April 1st, 2023. This means that states are reviewing every single case to determine if the member is eligible or not.
Federal Facilitated Marketplace (FFM)
The FFM will allow an SEP for those losing Medicaid coverage from April 2, 2023, to July 31, 2024. If a member has lost Medicaid coverage, they can apply for marketplace coverage anytime within this timeframe.
Your Health Idaho (YHI)
YHI will allow a 60-day SEP window following the date Medicaid coverage will end. Consumers will be able to declare they have lost Medicaid coverage, which may be validated using the Department of Health and Welfare’s (DHW) records at a later date. Those whose records cannot be validated against DHW’s records will be required to provide other documentation to support the loss of Medicaid coverage.
Nevada Health Link (NHL)
NHL will allow a 60-day SEP window following the date Medicaid coverage will end. Consumers will be able to declare they have lost Medicaid coverage, which may be validated using Nevada Health Link records at a later date. Those whose records cannot be validated against Nevada Medicaid records will be required to provide other documentation to support the loss of Medicaid.
We know that some of our members are at risk of losing their coverage. What can you do right now if you have a Medicaid plan?
- Make sure that your contact information is up to date. You can call 1-866-608-9422 to update your information or make sure that it is correct.
- Check your mail for a letter. You are going to receive a letter informing you about your coverage.
- Complete your renewal form, when you get one, to find out if you can keep your Medicaid.
What if you can’t stay on your Medicaid plan?
If you find out that you can’t stay on your Medicaid plan, don’t worry you can stay covered. We offer lots of great plans to fit most budgets, ages, and lifestyles. You can enroll on our Individual & Family plans right now with a Special Enrollment Period. Plus, you may qualify for help through an Advanced Premium Tax Credit or Cost Share Reduction, depending on how much money you make. These provide access to lower cost plans and premiums.
Learn more and shop plans in your area:
Do you have more questions?
We are happy to help! Call us at 888-493-2440.