Are you looking for information about Medicaid Renewals or Unwinding? Check out the previous post – Medicaid Renewals, Unwinding, Public Health Emergency – What does it all mean for me and my Medicaid?
Do you have a letter stating your Medicaid is ending? Here are three options to make sure you stay enrolled in health care coverage. You may be eligible for HealthCare.gov, you may be eligible for your employer insurance or maybe you are eligible for Medicare.
I’m over income for Medicaid and my employer doesn’t offer insurance.
You are eligible to enroll at Healthcare.gov for health insurance.
You are eligible to enroll at Healthcare.gov for health insurance. You may be eligible to receive tax credits to lower your monthly premium payment and for cost-sharing to lower your deductible, co-pays, maximum out-of-pocket, and other costs. You can complete an application and enroll as soon as you know Medicaid’s end date. If you want help or have questions, WHP staff are Certified Application Counselors and Navigators trained to answer questions, help submit applications and choose health plans. Contact us at 734-544-3030 or whp@washtenaw.org.
Confirm that Medicaid is ending. MDHHS sent you a Determination Notice saying Medicaid is ending. Medicaid always ends on the last day of the month. You need this date to complete your application at Healthcare.gov.
Login to Healthcare.gov. If you have an account from the past, use the login and password or reset your password if you forgot it. Creating more than one account causes problems. If you do not have an account, create one. You must have a valid email address and will complete an identity verification process that asks questions based on your credit history. You may be asked to upload your identification if you do not have a credit history. If another family member enrolling on Healthcare.gov has a credit history, create the account in their name.
Complete and submit an application. Pay special attention to any questions about when Medicaid ends. If you have questions about how to answer questions, save your application, and contact the WHP or find local help here.
Review your eligibility notice. Are you approved for a Special Enrollment Period? What day will your coverage start? Is the income listed correctly? Do you have to submit any verifications for income or immigration status? The eligibility notice is full of useful information. But if something doesn’t seem right or you aren’t sure if it is correct, please contact the WHP or find local help here.
Select and enroll in a plan. There are many filters you can select to narrow your plan choices. Add your doctors and medications to make sure your plan covers what is important to you. Compare Bronze, Silver, and Gold plans. Compare deductibles, copays, and out-of-pocket costs for different plans. If you have expensive prescriptions, mental health needs, or other special health care needs, WHP staff can help you compare and select plans.
Unwinding Special Enrollment Period. If you lose Medicaid anytime after March 31, 2023 and before July 31, 2024, you qualify to enroll at Healthcare.gov. Usually, you must enroll within 60 days of the end of Medicaid. Because of the unprecedented number of people who enrolled in Medicaid during the pandemic, this Special Enrollment Period will help people access health care coverage.
I’m over income for Medicaid and my employer does offer insurance.
You may be eligible for HealthCare.gov insurance OR your employer insurance.
Confirm that Medicaid is ending. MDHHS sent you a Determination Notice saying Medicaid is ending. Medicaid always ends on the last day of the month. You need this date to complete your application at Healthcare.gov.
Is your employer insurance affordable? Ask your employer how much it costs to enroll in health insurance. You will need the cost for everyone who is losing Medicaid and for your entire family. For 2024, it is considered unaffordable if your cost to cover the entire family is more than 8.39% of the total family income.
Employer insurance cost for all family members = $600/month
Total family income = $68,000/year or $5,66/month
Calculate 8.39% of family income: $5,666 x .0839 = $475.37/month
$600 is more than $475.37. Employer insurance is unaffordable.
If your employer insurance is unaffordable, compare your employer insurance with Healthcare.gov plans. Healthcare.gov may offer a better, more affordable plan. You may be eligible for tax credits to help pay your monthly premiums and for cost-sharing to lower out-of-pocket costs. Follow the steps above to complete an application at Healthcare.gov. The application will ask about your employer’s insurance costs for the family.
If your employer insurance is affordable, enroll in your employer insurance. You are eligible for a 60-day Special Enrollment Period. Employer insurance Special Enrollment periods are usually 30 days for qualifying events – marriage, divorce, death or birth. When you lose Medicaid, you can enroll in your employer insurance for 60 days after your last day of Medicaid coverage. Employers may need to be reminded of this federal rule. Here is a document from the Department of Labor that explains the 60-day SEP: FAQs on HIPAA Portability and Nondiscrimination Requirements for Workers
I think I’m still eligible for Medicaid.
Medicaid eligibility is based on the Federal Poverty Level Guidelines (FPLs). Medicaid uses the 2023 FPLs from April 1 to March 31, 2024. For adults ages 19-64, the income limit is 138% FPL; for children, the limit is 217% FPL. Use the chart below to find the income limit for you or your children.
If you fall within the guidelines, you can appeal the denial by requesting a hearing or reapplying for Medicaid. More information about Medicaid Appeals. Apply for Medicaid at MIBridges.
If you want to discuss your options or have questions, WHP staff can help you determine your options and next steps.
Many situations have other requirements, income limits, or are complicated, These complex situations include immigration, pregnancy, self-employment, cash income, complex family situations, asylees, refugees, work permits, and more. WHP staff are very knowledgeable about options and how to enroll and select plans. Each person in your family may be eligible for a different program! How confusing is that!?