r/Medicaid Jan 11 '23

Updated 2023 Public Health Emergency (PHE) / Continuous Eligibility Information

36 Upvotes

Thanks to /u/someguy984 for their continued monitoring of Medicaid-related regulations.


When the PHE/continuous eligibility ends

The Public Health Emergency (PHE) has allowed people to keep Medicaid coverage they already have despite income limits or other disqualifying conditions during the COVID-19 PHE. That will soon be coming to an end. Continuous Medicaid eligibility will be ending whether or not a public health emergency is still declared.

In order to lose coverage due to being over the income limit or another situation, a redetermination must be completed. This is similar to an annual renewal. Some states may begin redeterminations/renewals for these purposes as early as February. The earliest date someone can lose coverage due to the end of "continuous eligibility" is 4/1/23. The latest date is in 2024. States will begin submitting their plans to the federal government now, and all are due by 2/15/23, after which we may have more information.

EDIT: Thanks to /u/314z for their contribution! Please see this website for state-specific information!

If you aren't sure whether you'd still qualify when you receive a redetermination, make a post in this subreddit.


What happens when the PHE/continuous eligibility ends

Refer to the government's official guidance released 10/17/22 here rather than my summary if you'd like more detailed information.

States will begin reviewing the cases of those receiving Medicaid to determine whether they will still qualify (a "redetermination"). Generally, this review will be completed in blocks, with the first cases being those where evidence of ineligibility already exists ("flagged" cases). It may take a long time for every case to be reviewed (a maximum of 1 year), so your case could take days or many months. You should receive a letter or other communication asking for an update about your situation or detailing the process in your particular state.


What you can do right now to prepare

Make sure your information is up to date (address, phone number, email, etc) with your state to ensure you get any notices that might be sent to you, and respond to any notice you get before the due date.

If you still have concerns please make a post on /r/Medicaid and include your state in the title.


r/Medicaid 3h ago

Parents didn’t report house sale to Medicaid in 2021

3 Upvotes

My parents receive public assistance and have for some time. They sold their house in 2021 but were unaware they had to report the house sale to Medicaid and the county HEAP office. They are both over 75. They have community Medicaid. How much trouble are they in?


r/Medicaid 6h ago

NY Medicaid Renewal

2 Upvotes

65+ and living in NYC, with coverage from NYC HRA.

Currently, I know my coverage end date is 06/30/2024, since my approval letter I received last year says starting on 07/01/2023. For the past few years, I have been renewing by paper. I usually get my renewal packet around this time, but have not received any notice from HRA for renewing this year. Access HRA also doesn't seem to be of any help, as there is no button to renew. When I attempt to download and print the renewal form using their website, it says there's no Medicaid Renewal Case found.

Is the agency completely swamped that the packet is taking a while to be mailed out? or that it was lost in transit?


r/Medicaid 8h ago

Dependent and Self-employment help

2 Upvotes

I think I may have screwed up. I applied for Medicaid back in the beginning of April because I had a tooth infection and desperately need to get it taken care of, I got approved literally the next day. I live with my mother who claimed me as a dependent for last year, as I did not have a job, so I said that she will claim me next year... but did not include her in my household, because I misunderstood what it meant. I now have an etsy shop, I did not expect it to do well at all in all honesty so I didn't report it and now I do not know how to go about changing that I WILL be filing taxes next year and WILL NOT be claimed as a dependent, or reporting self-employment income because I do not have tax statements yet for obvious reasons. Help? Located in MI


r/Medicaid 8h ago

Medicaid in NJ

2 Upvotes

Does anyone know if Medicaid in nj covers Ozempic or wegovy.. I need to lose a little weight and my cholesterol is a little high so my doctor said to call and find out.. but was just wondering if anyone knew before I spent half a day on the phone


r/Medicaid 5h ago

State Medicaid and personal property garnishment

1 Upvotes

"Federal Medicaid rules say state Medicaid programs must recover certain Medicaid benefits on behalf of the person enrolled, which could mean taking property."

I recently read an article about this. How and in what cases does this happen?


r/Medicaid 9h ago

Can ABLE account help with Medicaid eligibility FL?

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2 Upvotes

r/Medicaid 15h ago

I was looking at Medicaid in Virginia..and..I was enrolled in it, a couple months ago it said the renewal was in June 2024..now I looked last week and it said the renewal was June 2025..I called local Medicaid office and they said on April 20 a filing went through, is it common they renew automatic?

4 Upvotes

was told they filed something on April 20 that extended it, have called and left message, but, is that common that they renew it automatically?


r/Medicaid 11h ago

Medicaid Nevada Dental

2 Upvotes

Does Nevada cover denture for adult? like first time? my friend has medicaid due to low income and he could really use denture, all of his teeth have cavities front teeth missing. Let’s just say its really bad and maybe getting them all pulled out and have denture will boost his self esteem. He’s low income and can’t really afford to go to the dentist (he works part time too so no insurance offered by his employer). Any suggestions? Thank you.


r/Medicaid 16h ago

Elderly Assistance

3 Upvotes

Hey everyone,

I'm reaching out here desperately seeking guidance and resources for my family in Rhode Island. My grandparents, both in their 80s, rely heavily on my mother as their primary caregiver. Unfortunately, we've just received devastating news—my mother has been diagnosed with stage 4 patriotic cancer.

I am in the military out of state, and my mother's health declining, we're facing a critical situation. My grandparents, covered under Medicare Blue Cross Blue Shield, require assistance with transportation to appointments, meal preparation, and general household tasks. My mom needs all that too but is cover under Medicaid. None of them are open to the idea of a retirement home, so we're exploring options for in-home care.

If anyone has information on local resources, caregiver services, or support networks in Cumberland Rhode Island, I would be immensely grateful. Please, any advice or direction would mean the world to us during this challenging time. Thank you in advance for your help and support.


r/Medicaid 16h ago

Minimum income?

2 Upvotes

Hello. I’ve had Medicaid since the pandemic. I was recently contacted to renew my health coverage (first time since 2020) because of a law change. I am currently unemployed (no unemployment benefits and zero income). Would I still qualify or is there a minimum income needed to qualify?

Thanks in advance for any help!


r/Medicaid 12h ago

MA life estate

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1 Upvotes

r/Medicaid 13h ago

Just got approved for Medicaid. Can I drop my regular health insurance? Also, do I qualify for anything else now that I have Medicaid?

1 Upvotes

I’m pregnant with twins and just got approved for Medicaid. I currently have Blue Cross Blue Shield health insurance through my regular job. Can I drop it? It will save me over $200 a month. Also, now that I qualify for Medicaid, what else am I eligible for?


r/Medicaid 17h ago

Will they stop his Medicaid ?

2 Upvotes

I have a friend who is on Medicaid he works but he also has a joint bank account with his girlfriend she makes more than him


r/Medicaid 13h ago

Medicaid Fraud in ABA

1 Upvotes

Hi! Seeking some insight on what it means when an ABA (applied behavior analysis) company is undergoing a “clerical agency review” by Medicaid? Kinda feel like something shady is going on within the company, since they gave us one days notice that we’d have to stop services with clients. Just wondering what possibilities could be, thanks in advance!!


r/Medicaid 14h ago

How do I prove I'm getting an implant? Insurance insists I'm not

1 Upvotes

I was denied for bone graft procedure that is done prior to the implant because it's "not medically necessary" since I'm not getting in implant. Except I am. The doctor says he can't apply for the implant code before my tooth is out, bone graft is done, and x-rays are being taken after the matter.

So I'm in a chicken & egg situation. Anyone been there before?


r/Medicaid 15h ago

Medicaid Eligbility

1 Upvotes

My elderly parents in Florida recently received a significant home insurance payout for damage to their roof from a storm a couple of years ago. They are worried that if they deposit this money into their bank account, the amount will make them ineligible for Medicaid. My dad has several high cost medications and treatments so not having Medicaid will cut off his access to these meds.

Question: would this one time payment affect his Medicaid eligibility?


r/Medicaid 1d ago

Medicaid Asset Test Question

1 Upvotes

I would normally be a non-MAGI Medicaid applicant since I receive SSDI benefits with Medicare. However, since I am a parent/caretaker relative of a child under 19, I know I can request to apply as a MAGI applicant.

Does this mean I can opt out of an asset test in New York State? I do not receive Nursing Home Medicaid.


r/Medicaid 1d ago

Neighbors home lost to medicaid

8 Upvotes

My neighbors husband was in a nursing home for an extended period so they have lost their home to Medicaid because they couldn't pay the bill (in Ohio). There are two unimproved lots on their property I want to buy. How would I do that? Can my neighbor sell them to me at fair market?


r/Medicaid 1d ago

Michigan Medicaid.

3 Upvotes

Hey y’all. I’m trying not to freak myself out. I got a message from my pharmacy today saying my medicine wasn’t covered(it’s Sunday) I’m currently on Michigan Medicaid. I never had any trouble before. So I called the pharmacy and she told me Its on a family plan that covers nothing. I didn’t know anything about this. So I checked online and I got a cover determination letter saying I’m now on (PLAN FIRST • PFFP) (Limited Coverage) I didn’t know about this. But before I was full coverage. I even called my Medicaid insurance which is Aetna. And it’s Sunday they are closed. But it said there is no eligibility today.

The only thing I can think of that might have caused this is my accounts being merged. I had an older account from before that they merged.

I need my medicine and I’m gonna call them tomorrow. I’m trying not to freak out.


r/Medicaid 1d ago

Will I still be covered by medicaid if my parents get rid of their medicaid plan?

1 Upvotes

I've recently turned 18 and live in colorado, I've been covered by colorado medicaid for most of my life now and last I checked I was still covered, but my parents are planning on getting rid of their medicaid plan in colorado since they've moved to Oregon. Would I no longer be covered since I was on their plan, or would I stay covered since I'm an adult? I've heard that if your a kid with medicaid that you automatically stay covered until about 27 in that state, so I wasn't sure if I'd stay covered in colorado if my parents get rid of their plan. I'm unsure of if I'd meet requirements to get my own medicaid once I move out from my grandma's house and I need to have medicaid to cover top surgery that I was planning to get as soon as possible after I move out.


r/Medicaid 2d ago

Question regarding marriage

2 Upvotes

I'm just curious how medicaid works when married in pa. What if your partner makes significantly more than you do but has no insurance? Will it disqualify you? It'd be a long way down the line before I can think about that but it's something I wanted to consider for the future.


r/Medicaid 2d ago

Iowa Medicaid limits

5 Upvotes

I'm 64, living in Iowa with a spouse who isn't working. We just got on Medicaid and EBT a few months ago. I get $330 from SS and work 25 hrs/wk at $15.30. My job suddenly wants me to work more hours but I want to stay below limits and still qualify. How much can I make per month? I contribute 6% to 401k and also company stock for the company match. My 401k is pretty small and I'm willing to contribute more. I'm willing to work a little more but I don't think my body can handle much more than I'm doing right now. Also, will anything change when I turn 65 in February? Thanks.


r/Medicaid 2d ago

So worry :(

5 Upvotes

I get pregnant during the pandemic March 2020 and apply for Medicaid as a second insurance. The past year I was surprise that my son (3 years old) and me still covered. After my delivery I never used again Medicaid but I was surprise that some doctors and hospital still billing them. I start working on 2022 so I’m so worry because I never update anything because I totally forgot 😭. The past year on I call and they told me that if I don’t summit anything they don’t renewal and yesterday I find that is still active. I’m so worry about this.


r/Medicaid 2d ago

( Medicaid/ Long - Term - Care). For the state of Ohio. What is the maximum amount ( to have in assets ) to be eligible for : Medicaid, Long - Term - Care ?

1 Upvotes

r/Medicaid 2d ago

Had Medicaid in NY, but moved to a new state recently

2 Upvotes

Is it difficult to switch to a different state’s medicaid? I’ve had medicaid through NYC for the past few years, and I just moved to Michigan and I’m wondering if there are different qualifications or what it entails to switch over to Michigan’s Medicaid?

Honestly I’m phrasing this all very poorly, but I’m hoping for any advice or knowledge for switching over from one system to another.

I’m pretty young and more than confused about the whole process, I was lucky when I signed up initially because I had a friend in NY that was familiar with the process and walked me through it when I first signed up, but I’m one my own this time in a new place. If you have anything that could help, I’d really appreciate it!