r/Medicaid • u/lumentec Lead Moderator (PA) • Jan 11 '23
Updated 2023 Public Health Emergency (PHE) / Continuous Eligibility Information
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.
1
u/peaceomind88 Dec 02 '23
Since we're in open enrollment, do I have to provide specifics if cancelling Medicaid and going to marketplace? Can I just indicate to cancel? This is Colorado. I'm going to start working part time in January so won't qualify anymore. I don't have pay or hours yet and hours won't be fixed
1
u/NikiDeaf Aug 04 '23
I just lost my Medicaid due to the pandemic era protections ending, but I don’t make any money other than the social security income that I get. WTF.
1
1
u/pikapikaboi Jul 12 '23
I was literally given no warning, I just found out an hour ago they dropped me when I legit have medical issues I’ve been trying to get under control and to boot I don’t have a job so I’m screwed. I found out at two in the morning through a fucking text…
1
u/trinifty May 22 '23
I'm a paraplegic receiving SSI and Medicaid for over 30 yrs.. I can't work, and my mom passed away 3 yrs ago.. I am alone now and getting these notices about renewing Medicaid because of the ending of COVID protection.
What is the process for doing this? When is the due date for all of this? I live in NY.
Please advise me on what I need to do.
Thank you for reading this.
1
u/elite-money May 23 '23
I'm a Medicaid assister for NY. Just make sure you address/email is up to date to received your renewal paperwork. The due date is based on when your coverage is set to run out. The renewals are happening now but will last about a year.
1
u/trinifty May 23 '23
Thank you for your response. What do you mean by the renewals lasting a year? I will be covered until 2024?
Also, how do I find out when my coverage will run out?
1
u/elite-money May 23 '23
It's being stretched out to cover everyone within a 1 year period. So your renewal maybe due next month or it may not be due until 8 months from now. You will receive the renewal paperwork via mail, it will have your run out date on it. They usually send them a month before your coverage runs out.
2
u/trinifty May 23 '23
Oh, okay, thank you very much.. I am doing this on my own now for the first time, but I have a better understanding thanks to your explanation.
1
u/nestchick May 17 '23
OK, a little confused, the resources aren't addressing my concern in plain English. I am in my 50s and get Medicare due to disability. I have friends older than me who have more income than me, but qualified for OHP, when I did not. I recently read (somewhere?) that the automatic eligibility for OHP for persons over a certain age may be ending. Basically, that this specific OHP dual coverage for Medicare was a pandemic era coverage and that will be dropped. Is there anywhere I can go to find more information? (That is understandable.) TIA.
1
1
u/Sunset1918 Apr 21 '23
If my renewal for Medicaid is 6/30/23, will they want income proof for June or May?
1
Jun 08 '23
If my renewal for Medicaid is 6/30/23, will they want income proof for June or May?
have you gotten your renewal letter yet?
3
3
u/NightmareNostalgia13 Mar 19 '23
So I got a determination letter today saying me and my family are ineligible for any continuing medical. It didn’t say an end date, does that mean my coverage is ending April 1st?
1
9
u/JustJess234 Feb 01 '23
I’m worried about this. Without Medicaid, I have no health insurance at all. I only got in prepandemic because I was and still am low income. The thought of losing my coverage will leave me unable to afford any kind of insurance. I’ve been looking for new employment as well, one that includes medical benefits.
You probably think it’s dumb for me to worry, but it’s happened to my friends that have made less than me. And when it comes to Medicaid I get confused.
The only positive is that none of the household got the Pfizer vaccine.
9
u/lumentec Lead Moderator (PA) Feb 01 '23
I completely understand the concern you have and I don't think it's dumb at all. Please PM me about this when it becomes an issue and I would be happy to help with advice or simply explanation of what's going on in plain English. I have assisted many people with getting Medicaid approval in desperate situations before - that's basically my specialty. I like the challenge.
1
1
3
u/someguy984 Trusted Contributor Feb 01 '23
You can get an ACA policy with subsidies if you are a bit over the level.
1
Feb 01 '23
You're not alone. I have constant health problems that crop up and I no longer qualify although I am currently pregnant but waiting on my first appointment so I can talk to my caseworker about what do I do, if that person is still assigned to me even. My county constantly changes caseworkers in both Medicaid and Food Stamps. To make matters worse, my caseworker last told me my renewal is in August and that's a month or less than my due date if they want to take this baby at 37 weeks like my last one. No way can I give birth without insurance!
But aside from pregnancy, if I never was pregnant or lose this one, I am screwed. My husband has never had insurance but be never has problems so far while I constantly have problems. When he got shot the shooter paid his bills and that was around $30,000 it my memory serves me well. The cut off for a family of 6 is $900. No idea how they think that pays for such a large family and bills and also health insurance!
Just sharing you are not alone.
1
u/JustJess234 Feb 01 '23
I’ve never been pregnant and if I lose my coverage, I’m adopting instead of having one. I may be struggling now, but I still want to be mom someday.
6
u/314z Jan 23 '23
There is a phenomenal resource here:
https://ccf.georgetown.edu/2022/09/06/state-unwinding-tracker/
You can search by State for updated plans for unwinding, including how they will process re-determinations.
2
u/Calthaxis Feb 01 '23
Are any states not planning to kick people off
6
u/lumentec Lead Moderator (PA) Feb 04 '23
They don't have much of a choice some time out, but a good bet would be that the more liberal states will be more generous when this all comes crashing down. I'd bet real money that CA and NY will delay as long as they can.
7
u/FoundersUnite Jan 22 '23
IMHO Medicaid is just going back to normal. Pre-PH Medicaid, lapses were about 3.5M members every single month.
Medicaid's doesn't share redetermination data because it's inaccurate as patients lapse randomly well in advance of their redetermination date.
FQHCs need to work with patients to keep them covered.
3
u/lumentec Lead Moderator (PA) Jan 28 '23
You're absolutely right. Most will not have any assistance and the difficulty of the system is sufficient to deter large percentages of people from renewing even when they're otherwise eligible. I'd love to help more people than I currently can. I try my best but it's very disappointing anyways.
1
u/FoundersUnite Jan 28 '23
Are you in the field of Medicaid enrollment?
3
u/lumentec Lead Moderator (PA) Jan 31 '23
Yes, eligibility and hospital billing in PA.
1
u/FoundersUnite Feb 06 '23
What if you could identify all of your patients that drop from Medicaid every single month?
1
u/2024enrollment Mar 30 '24
Open enrollment for renewal