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Since the beginning of the COVID-19 pandemic in early 2020, no one has been removed from Medicaid for being ineligible. But new congressional action has begun the “unwinding” of those pandemic-era benefits.
Ohio’s benefits renewal process started back up on Feb. 1 after three years on hiatus, meaning Ohioans who are still eligible will need to check in with the state and make sure their information is up-to-date, and those who are no longer eligible will need to find new insurance.
This article goes over everything you need to know about the process.
What changed at Medicaid?
In early 2020, at the outset of the COVID-19 pandemic, the federal government started chipping more in to Medicaid. But in exchange, states weren’t allowed to disenroll people from the program, even if they were ineligible, to ensure they didn’t lose health coverage amid a global health emergency.
The Ohio Department of Medicaid estimated its caseload will peak at about 800,000 cases higher than before the pandemic. There were nearly 2.8 million Ohioans enrolled in Medicaid as of February 2020, according to the Ohio Department of Medicaid. That grew to about 3.5 million residents by the end of 2022.
As of October 2022, Medicaid insured about one-fifth of the state’s population, including 3 in 5 Ohio nursing home residents and 3 in 8 people with disabilities in the state, according to the Kaiser Family Foundation.
A federal appropriations bill passed in December set the rule prohibiting states from removing people from Medicaid to expire at the end of March 2023, meaning Ohio is now reviewing members’ eligibilities once again.
About 280,000 enrollees in Ohio are expected to be deemed ineligible as the benefits “unwinding” process continues over the next year, the state currently estimates. That’s about 60,000 more people than the state estimated earlier this year.
The Ohio Department of Medicaid sent renewal packets to verify enrollees’ information between Feb. 21 and March 1. Termination notices started going out on April 1. Those who get a termination notice were still covered through the last day of the month they received the letter.
As of May, 24,000 Ohioans have been referred to insurance navigators to help them find alternative coverage through the federal health care Marketplace, an Ohio Medicaid spokesperson told FOX 8 on Thursday.
What you should do right now
Make sure your county Department of Job and Family Services has your current contact information — your name, home or mailing address, phone number and email address. Most often, members are disenrolled because they miss deadlines or gave incomplete responses in their renewal paperwork.
You can update your information in a few ways:
- By calling 1-844-640-6446 between 8 a.m. and 4 p.m. Monday through Friday
- By logging into benefits.ohio.gov and selecting “Access my Benefits,” then “Report a Change to my Case”
- By contacting your county’s Job and Family Services office, which you can find here.
Check your mail for a renewal letter from your county JFS office and respond to requests for more information. The state is looking at information already on file for Medicaid members to determine if they’re still eligible, but some folks who need to submit more information will receive renewal packets by mail.
These letters are started hitting mailboxes after Feb. 21. If the packet is returned as undeliverable, the department will attempt to find the correct address — for instance, if you’ve set up a mail forwarding address. Job and Family Services workers in your county may also start trying to reach you by phone or email.
Those with Ohio Benefits accounts may also receive text messages or voice calls with automated prompts about their renewal status. They’ll be pointed at folks who are most likely ineligible or who haven’t returned their renewal packets.
The process will cycle monthly, with enrollees receiving communications when their benefits are expected to expire.
I’m no longer eligible for Medicaid. What now?
Those who are no longer eligible will receive a termination notice after April 1.
Those folks may be able to get covered through the federal insurance Marketplace at healthcare.gov. The loss of Medicaid or Children’s Health Insurance Program (CHIP) coverage is considered a Qualifying Life Event, meaning you’ll be able to apply outside of the normal enrollment period.
The Ohio Department of Insurance offers a directory of licensed insurance navigators across the state, who can help Ohioans find coverage.
Even if you’re no longer eligible for Medicaid, your child may still be eligible for coverage through CHIP, known in Ohio as the “Healthy Start” program. To be eligible, the enrollee must be:
- Age 18 or younger, or the primary caregiver to a child age 18 or younger
- A U.S. citizen, national or a non-citizen legally admitted into the U.S.
- Uninsured and ineligible for Medicaid
- Be in a household with an income at 206% of the federal poverty level. For a household of four, that’s $55,500 annually, before taxes.
No one will be disenrolled from Medicaid until their eligibility has been re-determined and after two failed attempts to get verification from the enrollee.
You can also appeal the disenrollment, but that must be done within 15 days of the notice to keep your coverage. You’ll stay covered until the appeal is resolved.