If you lost Medicaid coverage, how to get health insurance

Millions of Americans could lose Medicaid coverage now that pandemic-era protections have expired. Here's how to find new health insurance.

Since the end of pandemic protections for Medicaid recipients this spring, there has been a major upheaval in the nation’s healthcare system.

Many patients are confused as to how they can get a new medical insurance.

Taffy Morrison said, “It is an overwhelming task.” She works to connect Louisiana residents with new coverage via the nonprofit Southwest Louisiana Area Health Education Center. But Morrison reminds people: “Don’t panic. Help is available.

Many of those who have been kicked off Medicaid (a federal-state health insurance program for people with low incomes or disabilities) will get new insurance through their employer. Some may have to use the online marketplaces of the Affordable Care act to replace their insurance.

Elevance officials informed investors mid-July that they saw signs of people moving from Medicaid to exchanges plans, as states continue to review who is still eligible for the public insurance programs. The company, which was formerly known as Anthem, has reported an 18.2% increase in exchange plans compared to the previous year. Its marketplace plans cover at least 949,00 people.

Some states, like California and Rhode Island will automatically enroll those who lose Medicaid into such marketplace plans to prevent gaps in coverage. Morrison, and other workers from similar nonprofit health groups across the country are helping people to navigate the administrative process involved in finding the best plan. Known as

Consumers need to be cautious about anyone who charges them to help them find coverage or push a specific plan. Incorrect marketing led some consumers to purchase plans that weren’t insurance. For example, Health Care Sharing Ministries don’t cover medical expenses.

With the federal Covid protections against pandemics ending, there is a dramatic change in insurance coverage. States were prohibited from cutting off Medicaid enrollees during the pandemic in order to guarantee that people could access health care. In response, the program increased by 30% between February 2020 and December 2022, covering about 92 millions people, including the children covered under CHIP (the Children’s Health Insurance Program). For the first time in 2020, states are now checking if enrollees still qualify.

The first set of numbers is coming in. So far, over 3.7 million people are without coverage in 39 States and District of Columbia. According to data from the state, in just June, over 50,000 people lived in Louisiana. In a month, the state examined the files of more than 151,000 Medicaid beneficiaries. Nearly 13,000 no longer qualified but 38,000 others lost their coverage because they failed to submit a renewal package for the state’s determination if they were still eligible.

Morrison’s 50 navigators will try to reduce these numbers, as the coverage losses are expected grow.

Patients’ advocates agree that Medicaid enrollees, regardless of their eligibility status, must complete and return the renewal packet.

Geoffrey Oliver is the leader of Connecting Kids To Coverage a program of Legal Services of Eastern Missouri which helps families with the enrollment process.

In the event that people are found ineligible after returning their forms, states will send their information to online exchanges like healthcare.gov. Exchanges will contact people to share information about health plans and follow-up with them. This is a way of preventing people from going uninsured.

Insurance experts advise people not to assume that they cannot afford market plans. Most people can get coverage at low or no cost. Federal estimates indicate that approximately 2,7 million people will be eligible for plans with discounts. This represents about one third of those who are expected to not be eligible for Medicaid. About 1.7 million of those will be eligible for plans with zero premiums.

Filling out the packet is important because even if adults no longer qualify for Medicaid or have coverage through their employer, children could still be eligible.

The message on a billboard in Randolph County in Missouri reminds people to renew their Medicaid coverage in large, bold letters. According to a tracker maintained at Washington University in St. Louis, 34% of the people in this central Missouri county have Medicaid.

Adrianna MacIntyre is an assistant professor at Harvard who specializes in health policy. Uninsured people may delay preventive care and end up with crippling medical debt in the event of an emergency.

KFF reports that the majority of millions who have lost Medicaid benefits so far did not lose them because they were ineligible but rather because they failed to complete the paperwork . Patients’ advocates are concerned that enrollees might not have received their packet. Most recipients are likely to have moved or changed their addresses, but not updated the contact information they have provided with states. These issues could be more acute in Louisiana, for example, where there have been many hurricanes and floods over the last three years.

Medicaid recipients in some states can check online their status of eligibility. They can also ask for assistance from free navigators such as Morrison to check their packets.

What you need to know to navigate the insurance coverage path

It is important to complete, sign and return the Medicaid renewal packet.

You will have a special period of enrollment if you are denied Medicaid coverage. This allows you to enroll in another plan. Enrolling in a new Medicaid plan is usually possible 60 days prior to losing your coverage. The packets will arrive before you lose your coverage.

According to federal guidelines, you have 60 days after you notify the insurance company of your loss, and not from the date you lost coverage. According to federal guidelines, the clock begins once you submit your new application through healthcare.gov.

Plan ahead to avoid coverage gaps. Most coverage of the marketplace begins on the first day following the month.

Below are some options that you may want to consider for your family.

  • Sign up for insurance through your employer. If you lose Medicaid, there is a special window to sign up.
  • Sign up for an Affordable Care Plan. Your family and you may qualify for a plan that is discounted on the exchange if employer-based coverage does not exist or is too expensive. Your family would be eligible for financial assistance if your monthly premiums for the lowest cost family plan exceeded 9.12% of household income.

For example, workplace insurance might be affordable to a father but not the rest of his family. In this situation, dad should enroll in an employer-sponsored plan, and then the rest of the household should shop for insurance on the market, said Geoffrey Oliver.

You may still qualify for Medicaid if your kids are not eligible:

Children may qualify for Medicaid even if their parents or guardians do not. Children can be eligible for CHIP if their family income is up to 400% the federal poverty line. This equals $120,000 per year for a four-member family.

Before you turn 19, and lose your CHIP coverage, here are some things to do:

At age 19, some young adults may lose their CHIP coverage. It’s crucial that they, particularly those with chronic conditions, take advantage of this special enrollment period to enroll in an Affordable Care Act Plan before losing their public coverage.

If you are turning 19 at the end of a month, say September, you should select an exchange plan by August. Most marketplace coverage starts on the first of the next month. You will be covered when your CHIP coverage ends.

KFF Health News is the former Kaiser Health News. It is a national newsroom which produces in-depth reporting about health issues. This is one of KFF’s core programs. KFF is an independent source for research on health policy, polling and journalism.

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