Are You Losing Your Medicaid Coverage? 6 Things to Know

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Are you among those at risk of losing your Medicaid coverage?

The end of March will mark a harsh deadline for millions of Americans all around the nation who get medical care under Medicaid. Beginning April 1st, many states will withdraw individuals from the government health insurance program for low-income people, paring rolls that surged during the pandemic.

The government calculates that 15 million people, or approximately 1 in 6 of the 84 million who benefit from Medicaid coverage, will be kicked off the program.

Easy Seniors Club wants to talk about why this is happening and what you should know. Continue reading to get the facts about your Medicaid coverage!

Medicaid Coverage
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It has ALREADY impacted many

So, here’s a perfect example of what has happened so far. A man named Justin Gibbs, 53 years old, a married father of four who works multiple part-time jobs, with very high blood pressure, had finally gotten it under control with a combination of three prescription medications.

But after his Medicaid coverage was cut in December last amid a nationwide eligibility review, he had to go without one prescription for a week and a second for a few days, sparking fears that the delicate balance would unravel. “I was concerned that my blood pressure would spike, and I wouldn’t have any way to regulate it,” said Gibbs.

Justin is proactive about his health because he wants to stick around to watch his children grow up. Fortunately, an Ohio resident’s Affordable Care Act policy kicked in in January, and he was able to resume buying the medication he needed. He’ll soon begin a job with employer coverage. Nevertheless, a sizable share of the other 20.1 million Americans disenrolled from Medicaid in the “unwinding” over the past year aren’t as lucky.

Nearly a quarter of adults who say they were disenrolled report being uninsured now, according to a survey, which has tallied terminations since they began in April 2023. The survey sheds light on the effects of the strategy on enrollees and the outcomes, which are not well-tracked by the federal government or even individual states.

About half of those disenrolled recovered their Medicaid coverage, and more than a quarter are now covered through Medicare, an employer, an Affordable Care Act exchange, or another source, the survey found. Still, 7 in 10 of those disenrolled were left uninsured, and over half of them said they had to delay or skip getting care or medications during that period.

The loss of coverage also prompted three-quarters of them to stress about their physical health and 60% to worry about their mental health. “It was disruptive to people’s lives,” said Ashley Kirzinger, KFF’s director of survey methodology.

Overall, the survey found that 81% of adults enrolled in Medicaid before the unwinding said they were not disenrolled during the last year.”

What’s happening to Medicaid?

During the pandemic, the administration suspended certain procedures that would remove people from Medicaid. Before the crisis, individuals would regularly lose their Medicaid coverage if they began making too much money to qualify for the program.

The same would happen if they gained health care coverage through their employer or moved out of state. That stopped once COVID-19 arrived, causing Medicaid enrollment to increase by 5 million between 2020 and 2022.

The Consolidated Appropriations Act, signed last December as the pandemic continued to decline, instructed states to renew eligibility checks of every individual currently on Medicaid. To stay on the rolls, people will need to fill out forms to verify their personal information, including their income, address, and household size.

Medicaid Coverage
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When are people losing their Medicaid coverage?

Well, it really all depends on where you live. Some states have already begun the disenrollment process. The Associated Press conveyed that Medicaid coverage members who were no longer eligible could be withdrawn as soon as April in these 9 states: Idaho, Arizona, Florida, Iowa, New Hampshire, Ohio, Arkansas, Oklahoma, and West Virginia.

Yet, not all ineligible individuals will be dropped from the program at the same time because the states have set different timelines for re-checking the eligibility of Medicaid patients. Most states have to complete the verification process within nine months and a full calendar year.

What options do you have if you lose your Medicaid?

Some people who don’t qualify for Medicaid coverage anymore can get health insurance from the Affordable Care Act’s marketplace coverage, where private coverage subsidized by federal tax credits can cost roughly $10 a month, depending on their income.

A special enrollment period for those dropped from Medicaid begins March 31st and will last through July 31st. CMS noted that individuals who lose Medicaid coverage can submit an application anytime after losing it and will have up to 60 days to choose their plans.

Also, you don’t have to wait until your Medicaid ends to be able to apply for new coverage, but you can start using it 60 days before your Medicaid is scheduled to end. Still, coverage through the Obamacare marketplace or an employer often differs vastly from what Medicaid offers.

Even on employer-sponsored plans, out-of-pocket costs and copays could be higher than Medicaid, making it costly. Those changing their coverage must also check to see if their new insurance plans will still cover their physicians.

How are states notifying people about losing Medicaid?

As recently as the end of last year, two-thirds of adults benefiting from Medicaid coverage weren’t aware that the program rules were changing, according to a survey. The sad truth is that many people, including children, will lose coverage simply because they’re unaware of what’s happening.

That’s the concern, that many will go without coverage for months and then go through lots of red tape to reenroll. Healthcare advocates are encouraging people on Medicaid to update their contact information, including their phone number, home address, and email, with the state.

If you depend on Medicaid coverage, states mail a renewal form to your residence. The federal government also instructs states to contact you in another way (by text message, phone, or email) to remind you to fill out the form.

And even though most states have already used texting for reminders to attend an upcoming doctor’s visit or get a COVID-19 vaccine, sending mass texts on Medicaid eligibility will be something new. You should know that you’ll have at least 30 days to fill out the form. If you don’t, states can remove you from Medicaid.

Medicaid Coverage
Photo by one photo at Shutterstock

What happens to kids enrolled in Medicaid?

Over half of the kids in the US receive health care coverage through the Children’s Health Insurance Program or Medicaid. But even if an adult loses their Medicaid coverage, it doesn’t mean their children will.

Even if you get a notice stating that you’re not eligible for Medicaid anymore, it’s likely that your child still qualifies for the program or health care coverage through CHIP. CHIP covers kids whose families make too much money to be eligible for Medicaid but don’t make enough to afford private health insurance.

Between 80% and 90% of kids will still be eligible for those programs, according to the Georgetown University Health Policy Institute.

When a parent gets a message saying that they’re not eligible anymore, they usually assume their child isn’t either. But it’s more standard to find that the parent is no longer eligible for Medicaid, but the child still is.

What are YOUR thoughts? Do you think these new rules will affect your Medicaid coverage? Please feel free to share your thoughts with us in the comments section below.

For more on this subject, check out The Medicaid Planning Guidebook from Amazon!

In the meantime, if you found this article helpful, we highly recommend also reading: 14 Ways To Lower Your Living Expenses In 2025

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