Posted on Mar 01, 2023

Medicaid Eligibility

Are You At Risk Of Losing Medicaid Coverage?


If you are receiving health care coverage from Medicaid, you might be at risk of losing eligibility over the next year. Medicaid coverage has grown by 20 million people since January 2020, which was just before the COVID-19 pandemic hit.

States have begun checking everyone’s eligibility for Medicaid for the first time in three years, and as many as 14 million people could lose their eligibility. Continue reading this article to find out why so many people may no longer qualify for the Medicaid program over the next year and what you need to know if you’re one of those people who relies on the program.

Why am I at risk of losing Medicaid?

At the beginning of the pandemic, the federal government prohibited states from kicking people off Medicaid, even if they were no longer eligible. Prior to the pandemic, people would regularly lose their Medicaid coverage for many reasons, such as, if they started making too much money to qualify, got health care coverage through their employer, or moved into a new state. That all stopped once COVID-19 started spreading across the country.

Over the next year, states will be required to start checking the eligibility of every person who is on Medicaid. People will have to fill out forms to verify their personal information, including address, income and household size.

When will they begin checking eligibility?

This will be different for everyone, depending on which state you live in. Some states are moving faster than others, such as Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma and West Virginia. They will begin removing ineligible Medicaid recipients as early as April.

Other states will start taking that step in May, June or July. States plan to verify all recipients’ eligibility over periods of nine months to one year, and not everyone will be removed from the program all at once. 

Will I be notified?

If you rely on Medicaid,  it’s important to update your contact information, including home address, phone number and email with the state from which you receive benefits. States will mail a renewal form to your home. The federal government also requires states to contact you in another way -– by phone, text message or email –- to remind you to fill out the form.

Even if mailed notices reach the right address, they can be set aside and forgotten, said Kate McEvoy, executive director of the nonprofit National Association of Medicaid Directors. Most states have already used texting for things such as reminding patients to get a COVID-19 vaccine or about upcoming doctor’s visits. 

You will have at least 30 days to fill out the form. If you do not fill out the form, states will be able to remove you from Medicaid.

What will my options be if I am no longer eligible?

Many people who will no longer qualify for Medicaid coverage can turn to the Affordable Care Act’s marketplace for coverage, where they’ll find health care coverage options that may cost less than $10 a month.

But the coverage available on the marketplace will still be vastly different from what’s offered through Medicaid. Out-of-pocket expenses and co-pays are often higher. Also, people will need to check if the insurance plans offered through the marketplace will still cover their doctors.

A special enrollment period will open for people who are unenrolled from Medicaid that will start on March 31 and last through July 31, 2024. People who lose Medicaid coverage will have up to 60 days to enroll after losing coverage, according to guidance the Centers for Medicare and Medicaid Services sent to states last month.

What will happen to my children's Medicaid coverage?

More than half of U.S. children receive health care coverage through Medicaid or the Children’s Health Insurance Program.

Even if you receive a notice that you’re no longer eligible for Medicaid, it’s likely that your child still qualifies for the program or for health care coverage through CHIP, which covers children whose families make too much money to qualify for Medicaid but don’t earn enough to afford private health insurance.

Read the full article by Spectrum News here.

MassHealth is always re-evaluating existing benefit recipients, looking for any reason to end their benefits. We can ensure that Monteforte Law, P.C. is dedicated to maintaining your or your loved one’s eligibility. You do not want to risk losing Medicaid eligibility for yourself or for a loved one, so let us help