WHAT'S HAPPENING
HAVE YOUR OR YOUR FAMILY LOST MEDICAID HEALTH COVERAGE? HERE'S WHAT YOU NEED TO KNOW
BY SAMANTHA LISS
The nation's health insurance system is undergoing tremendous upheaval as an estimated 8.2 million people will need to find new coverage since pandemic protections for Medicaid enrollees came to an end this spring.
MIND THE GAP: The most important step in retianing your Medicaid is to fill out, sign, and return your Medicaid renewal packet.
That’s leaving many patients confused about how to get new medical insurance.
"It’s an overwhelming task,” said Taffy Morrison, who is working to connect Louisiana residents to new coverage through the nonprofit Southwest Louisiana Area Health Education Center. But Morrison reminds people: “Don’t panic. There is help."
For many of those kicked off Medicaid, a state-federal health insurance program that
covers people with low incomes and disabilities, new insurance will come from their employers. Others may need to turn to the Affordable Care Act online marketplaces to replace their coverage.
Elevance insurance officials told investors
in mid-July they were seeing signs of movement from Medicaid to exchange plans as states ramp up reviews of who still qualifies for the public insurance program. The company, formerly called Anthem, reported 18.2% growth in its exchange plans from
COVER ME: PLANNING AHEAD TO AVOID GAPS IN HEALTHCARE COVERAGE
NAVIGATING THE PATH TO INSURANCE COVERAGE
The most important step: Fill out, sign, and return your Medicaid renewal packet. If you no longer qualify for Medicaid, that denial triggers a special enrollment period for you to find another source of coverage. You typically have 60 days before the loss of your Medicaid coverage to enroll in a new plan; the packets should arrive ahead of losing any coverage, so that should serve as a warning that a change in your benefits may be coming.
You also have 60 days from when you report the loss of coverage, not the date when you actually lost it, to enroll in a new plan. That clock starts when you submit a new application via healthcare.gov, according to federal guidelines. To avoid gaps in coverage, plan ahead. Most marketplace coverage begins the first day of the following month.
POTENTIAL COVERAGE OPTIONS FOR YOU AND YOUR FAMILY
Enroll in insurance through your job. Losing Medicaid triggers a special sign-up window for you to enroll in your employer's insurance, if available.
Enroll in an Affordable Care Act plan. If employer-based coverage is not available or affordable, you and your family may be eligible for a discounted plan on the exchange. If your portion of the monthly premium for the lowest-cost family plan exceeds 9.12% of your household income, your family members would qualify for an exchange plan that offers financial assistance.
Workplace insurance may be affordable for a father, for example, but not for the rest of the family. "In that situation, Dad should enroll in the employer-sponsored insurance plan and then they should go to the marketplace for the rest of the family," said Geoffrey Oliver, a navigator who leads Connecting Kids to Coverage, a program of Legal Services of Eastern Missouri.
YOUR KIDS MAY STILL BE ELIGIBLE FOR MEDICAID
Even if parents or guardians no longer qualify for Medicaid coverage, their children might. In some places, kids can qualify for the Children's Health Insurance Program, known as CHIP, with an annual household income of up to 400% of the federal poverty level, which equates to an income of $120,000 for a family of four. See aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
BEFORE YOU TURN 19 AND LOSE CHIP COVERAGE
Some young adults will age out of CHIP coverage at age 19. For them, especially those with chronic health conditions, it's important to take advantage of the special enrollment period for an Affordable Care Act plan before losing public coverage.
If you turn 19 in the middle of the month – say, September – you should choose an exchange plan in August because most marketplace coverage begins the first day of the following month. This ensures you will not experience a gap in coverage when CHIP coverage expires.