Dropping of Medicaid Continuous Coverage: How to Stay Insured

As of January 2023, 93,008,246 individuals were enrolled in Medicaid and CHIP (Children’s Health Insurance Program). Of these individuals, 85,915,795 had Medicaid, and 7,092,451 had CHIP.

Medicaid continuous coverage provided health care to individuals throughout the pandemic. Since Congress has officially removed Medicaid’s continuous coverage requirements, countless Americans may experience a loss of coverage.

You might be wondering what this means for those about to lose their health insurance. Are there ways to keep coverage or find new free or affordable plans?

The answer is “yes”. There are ways you can secure free health insurance, outlined in this helpful guide.

What Is Medicaid Continuous Coverage?

Part of COVID-19 relief included the Families First Coronavirus Response Act (FFCRA). This was enacted in March 2020 and allowed Congress to provide an increase in state Medicaid funding.

To qualify for and receive these funds, states needed to meet a variety of conditions. These conditions were called Maintenance of Effort (MOE).

States also had a “continuous coverage” requirement. This requirement prevented states from terminating coverage of the majority of Medicaid enrollees.

They were required to keep this coverage until the end of the public health emergency (PHE). This would be determined by the U.S. Department of Health and Human Services.

Throughout this requirement of continuous coverage, Medicaid was unable to disenroll Medicaid enrollees. The exception was if they requested to be disenrolled, moved to another state, or passed away.

This continuous coverage afforded millions of Americans uninterrupted coverage throughout the pandemic. This coverage was a major reason why the uninsured rate didn’t see a spike when the pandemic was at its peak.

Congress later passes a spending bill that removed Medicaid’s continuous coverage requirement, announcing this decision in December 2022. This continuous coverage protection was set to end on March 31, 2023. As of April 1, 2023, this would allow states to continue terminating Medicaid coverage.

Who Does This Affect?

It’s common for a loss of coverage to occur when a policy is set to renew. Even if a person is eligible for Medicaid, procedural reasons may cause a loss of coverage.

This includes unnecessary paperwork requests and long wait times to speak with someone at a call center. There are a large number of people set to lose coverage as Medicaid unwinds, regardless of eligibility requirements.

Those most at risk include anyone who moved during the pandemic and failed to update their mailing address. This also includes anyone who has failed to update other contact information. Anyone who failed to receive notices as a result may lose coverage.

Medicaid enrollees who received renewal information but didn’t complete it on time may lose coverage. This includes those who were unfamiliar with the renewal process. There was no renewal process for three years, and many people forgot how to renew their coverage.

Children and people of color are most likely to lose coverage. Despite being eligible for Medicaid, procedural issues during unwinding may cause a loss of coverage.

Additionally, anyone whose income has increased may no longer be eligible for Medicaid. Other circumstances not mentioned may also prevent individuals from receiving Medicaid.

How to Retain Health Care Coverage

There are several steps you can take to help keep your health coverage. Let’s take a look at what to do if you suspect you’ll be losing Medicaid coverage.

Reapply for Medicaid

First, ensure that your contact information is registered with the Medicaid agency. Next, keep an eye on your email, mail, and text messages or information regarding the renewal process. Always respond accurately and carefully and provide all the requested information by the due date.

You can always direct questions to your local Department of Social Services. Be sure to have all your requested information before calling, as you may be asked a series of questions.

Anyone who receives a letter stating that they no longer qualify for Medicaid can file an appeal. The determination letter will provide instructions for you to follow.

If you didn’t complete all the necessary steps and it’s within 90 days of when your Medicaid coverage is set to end, your state is required to accept your renewal paperwork. They have to process it and can’t require a new application.

Marketplace Health Insurance

Should you no longer qualify for Medicaid coverage, you can apply for a marketplace plan and enroll up to 60 days before your Medicaid or CHIP coverage is set to expire. You have until July 31, 2024, to complete this process.

If this is outside of the marketplace’s annual enrollment period, you can still apply. If you live in a state that uses HealthCare.gov and you have an income that is up to 150 of the poverty line, you can enroll for marketplace health insurance coverage at any time. Policies vary for states that have their own marketplaces for health insurance.

Employer-Sponsored Insurance (ESI)

You can also check and see if you qualify for insurance through your employer. You have to take action and enroll in ESI within 60 days of when your Medicaid is set to expire. If you fail to complete this step, you may have to wait until your employer’s next annual enrollment period.

CHIP

If your child is no longer eligible for Medicaid, they may qualify for CHIP. You can apply through your state’s agency or the CHIP program directly.

You can also apply through the marketplace. Even if your child is ineligible for CHIP, they may qualify for subsidized marketplace coverage, so be sure to apply today.

Get Your Free Health Insurance Quote

If you’re affected by a loss of Medicaid continuous coverage, help is only a phone call away. The “REAL” Insurance Lady (T.R.I.L.) works tirelessly to educate individuals about free and affordable insurance. T.R.I.L. also works to provide access to health, life, dental, and Medicare insurance for all.

T.R.I.L. offers free quotes for you and your family, discussing on-demand services and flexible healthcare plans to meet all your needs. We’ll lend support and assistance as you pick a new health insurance plan. Since 95% of all health insurance applicants can access free, no-cost health care, connecting with a health insurance agent is paramount in maintaining coverage.

Contact us today to get started.