Losing Medicaid benefits
Because of the recent Medicaid redetermination, many people are losing Medicaid benefits.
During the last 3 year period, Medicaid benefits have been automatically renewed for individuals who became eligible because of the public health emergency caused by COVID-19. During this time, beneficiaries were not required to recertify annually for Medicaid coverage.
Because the public health emergency has ended or “unwinding” as of May 11, 2023, the requirement to recertify for Medicaid coverage is back in place. This means there will not longer be any automatic renewal and Medicaid beneficiaries must prove the need for benefits.
In other words, beneficiaries will go through redetermination.
This process takes place each year and reviews each person’s need for health care assistance through their state government. It is important to reply to any valid communication you receive from your state’s department of Social Services or DSS. If you fail to respond, you may lose your coverage even if you do qualify.
Each state has 1 year to begin the redetermination process starting on March 31, 2023. All states must finish processing renewals within 14 months. In other words, beneficiaries may lose Medicaid coverage as soon as April 2023.
Millions of people will lose Medicaid coverage:
Although we do not know the exact number of people slated to lose coverage, it may be over 15 million. For many employment is a main factor in their loss of Medicaid coverage.
Some individuals will lose coverage due to not confirming eligibility with their state’s DSS offices before the expiration of their coverage. There also may be problems with a backlog of paperwork and a processing system that is simply overwhelmed. This can cause delays and coverage loss. This backlog has the potential to effect millions . That is why it is best to be proactive and go into your Medicaid account to ensure you are still eligible and covered.
What if I no longer qualify for Medicaid:
If you reapply for Medicaid and do not qualify, there are other low cost or even free healthcare choices available to you. The choices depend on your personal circumstances.
- If either you or your spouse/partner has an employer that offers health insurance coverage, you may qualify to join during either their open enrollment period or with a special election period.
- In the interim, if you are not yet eligible for employer based coverage, you can enroll in a short-term insurance plan while you wait to qualify. There are several options for these types of plans.
- You can also access healthcare through the healthcare marketplace. In many cases, beneficiaries may qualify for a subsidy and pay a low monthly premium. If you lose health coverage, you have a special enrollment period or SEP you can use to enroll in coverage. To find the market place for your state go to healthcare.gov/marketplace-in-your-state.
- College students may be able to purchase health coverage directly through a campus health plan. Students can get details from their registrar’s office.
- If you are either 65 or older or have a qualifying disability, you may be eligible for health coverage through Medicare. Contact a licensed Medicare agent for help going over all your plan options.
- Anyone who is either a veteran or an active duty service member may qualify for Tricare. Use the following link to get more information: Tricare healthcare coverage.
It’s important to note that if you believe you qualify for Medicaid, you should reapply. We’ll discuss that next. But even if you do apply, you may need to explore some of the options above while you wait to be approved.
How do I reapply for Medicaid benefits:
If you have limited income/funds, you may be eligible to retain your Medicaid coverage. If this is the case, Click here to for information on how to apply for Medicaid. Contact your state DSS office for applications and guidance.