Millions of people could be losing Medicaid coverage within the next 12 months, which is being referred to as, the unwinding of Medicaid. Kaiser Family Foundation estimates between 5-14 million people will be losing coverage during the unwinding period. What is the “Unwinding of Medicaid” & what should you know?  

At the start of the pandemic, congress enacted the Families First Coronavirus Response Act which included a requirement that Medicaid programs (in exchange for extra federal funding) keep people enrolled, even if they no longer qualify income wise. So we had clients that in 2020, (mostly self employed people) who’s income was significantly affected by Covid. Some loss their jobs or had to temporarily close their businesses. We helped them apply and get enrolled in Medicaid at that time. We eventually noticed that even when they went back to making their pre covid income and we reported the income change, they were allowed to stay on Medicaid. They could be making over 100k a year and still were allowed to keep their coverage on Medicaid.  

Well that provision is ending March 31st, so starting April 1st, the States that participated will start reevaluations (or renewals) and dis enroll people that no longer qualify for Medicaid (income wise). 

Each state must come up with a gameplan on how they will approach this. At this point, some states have decided to prioritize renewals, majority of the States say they will take 12 months to complete renewals and a small percentage has not decided on a timeframe yet. 41 States have posted their fun plan publicly.  

Many of these states will streamline their reevaluation process, as they can verify eligibly though state wage databases before sending a reevaluation request to the enrollee. They can basically see your income without even asking you for it. This would reduce the burden on enrollees & the program employees and you can see here which states and how heavily they are streamlining their reevaluations or renewals. 

So if you are currently on Medicaid and anxious to transition out of Medicaid (maybe you want to best the rush that’s coming), Centers of Medicare & Medicaid announced a special election period between now and July 31st of 2024 to submit your marketplace application, attest to a last date of Medicaid coverage and will have 60 days to enroll in a plan after submitting your application. Your coverage will start on the 1st of the following month.  

If you are in no rush to leaving Medicaid coverage, you will want to be on the look out for your re evaluation letter. You can check with the agency that administers your state’s Medicaid to see when you are due for your re evaluation.  If you are over the income limits to qualify for Medicaid or CHIP for your kids, you will be eligible for a special election period, a 60 day window to enroll on a marketplace plan.  

In states that have expanded Medicaid, the max income would be 138% federal poverty level for Medicaid. You can pre apply up to 60 days before your last day of coverage, which you might want to consider rather than to wait till everyone else is losing coverage and there’s a bottleneck of applications to process.  

The positive side is that by buying a marketplace plan, in some areas of the country, that means access to a larger network of providers. Also, a lot has changed within the last 2 years regarding getting your own healthcare coverage. More people today are qualified for a nice sized subsidy than ever, making coverage options affordable. You may find coverage on marketplace may be more affordable than you think! 

Don’t wait for the last minute…get with an insurance broker who can shop options for you. Someone who not only can help you with marketplace plans, but can also help you get non marketplace plans, in the event you don’t qualify for any subsidies.  

Watch our YouTube video, “Things to Consider when shopping for Health Insurance” so you know what to look for when choosing your plan, but we highly recommend getting a second pair of experienced eyes by working with a broker. There should never be a fee for using a broker.  

If you are not already working with a broker, reach out to the MediGap Pros team at 800-850-9657. We are licensed in most states and would be happy to assist you!