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Losing Medicaid? Here’s what you need to know and do

healthinsurance.org offers tips for millions of people expected to lose Medicaid

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Minneapolis, MN – Most states have begun disenrolling people who no longer qualify for Medicaid, and millions of people are expected to lose health coverage in the coming months. Healthinsurance.org has released several tips to help consumers stay insured if they’re losing Medicaid coverage.

“For millions of people, this will be the first time in at least three years that they need to find insurance,” said Louise Norris, health policy analyst for healthinsurance.org. “The stakes are high because many people don’t know what to do to stay insured.”

During the federal public health emergency for COVID-19, Medicaid disenrollments were put on hold. The continuous Medicaid coverage requirement helped millions of people continue to access health care during the pandemic. That requirement ended and as a result, an estimated 15 million people could lose Medicaid coverage. .

Here are some important things for people losing Medicaid to keep in mind.

1. Your employer’s plan may be the best option.

If you are eligible to enroll in a health plan through an employer, you’ll have an opportunity to do so when your Medicaid ends. But don’t wait. People losing Medicaid typically qualify for a special enrollment period from an employer-sponsored plan that continues for 60 days after their Medicaid ends. Signing up for employer coverage before your Medicaid ends can help avoid a gap in coverage.

“If you lose Medicaid, but your employer offers health insurance, that will likely be your best option,” Norris said. “Remember you only have 60 days until after your Medicaid coverage ends to sign up for your employer’s plan.”

Most employers help cover the cost of insurance, but if your employer-sponsored plan is not considered affordable as defined by the Affordable Care Act (ACA), you may qualify for help through the Marketplace. Use healthinsurance.org’s Employer Health Plan Affordability Calculator to determine whether employer-sponsored coverage of your family is considered affordable. (If it’s not, you may be eligible for subsidized ACA Marketplace coverage.).

2. Premium subsidies can help lower the cost of ACA Marketplace plans.

People who lose Medicaid can enroll in a Marketplace plan during an Unwinding Special Enrollment Period,  which lasts for at least 60 days after their Medicaid ends.

Millions of Americans who lose Medicaid are expected to qualify for financial help in the form of premium subsidies, which lower the cost of a health plan in the Marketplace.

To avoid a gap in coverage, people in most states should enroll in a Marketplace plan before their Medicaid ends.

“Resuming Medicaid disenrollments wasn’t intended to leave people uninsured. It was to ensure that people weren’t staying on Medicaid if they were no longer eligible,” said Norris. “Ideally, everyone who loses Medicaid coverage will enroll in a new health plan and stay insured.”

3. Children may still qualify for other government assistance.

Even if adults lose Medicaid coverage, their children may still qualify for Medicaid or the Children’s Health Insurance Program (CHIP). In every state, children are eligible for these programs at higher household income levels than adults. So even if an adult loses Medicaid, it’s worth checking whether children in the same household still qualify.

If children are not eligible for Medicaid or CHIP, you can explore coverage for them through an employer or your state’s Marketplace. Learn more about each state’s Marketplace.

“The most important thing to keep in mind if you are losing Medicaid coverage is that you want to stay informed, plan ahead, and take action to find replacement coverage,” said Norris.

Healthinsurance.org provides online resources for consumers about individual and family health insurance. Healthinsurance.org has been providing consumer information about health insurance and health reform for over 25 years.


Contact:

Amy Fletcher Faircloth [email protected]

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