Key Points:
- Starting April 1, 2024, new determinations for Medicaid eligibility have begun and if you have been given a notice stating you no longer qualify for Medicaid, you can have a chance to qualify for a plan on the marketplace.
- When you get that letter in the mail it is important to take action as soon as possible. The deadline to enroll in the new plan is 60 days from the date of this denial.
- If you miss this deadline you will have to wait until open enrollment which runs from November 1st to December 15th.
- Working with a broker is the best way to make this transition. Brokers are best trained on the plans that will help you in this transition and can help you get a plan that best fits your needs
What is Medicaid?
Medicaid is the state health insurance program. It is paid for through state tax dollars and eligibility varies by state.
It is estimated that more than 88 million people across the country are enrolled in Medicaid. But with new rules and regulations that made it easier to qualify for Medicaid, states are cracking down and looking into eligibility, and in some cases, dropping coverage entirely for individuals and families who once qualified.
This is problematic because, without this coverage, enrollees are now responsible for the cost of their bills and often can not afford to see a doctor or access medication without insurance coverage.
Who gets denied?
Usually, this denial comes because your income has changed from what you originally put on your application when you first applied for Medicaid. in the year 2020-2021 when the Covid pandemic caused a decrease in income or a job loss.
While states worked to expand their Medicaid eligibility requirements during this time, the legislation passed to make that possible had an expiration date, and that is now.
What do you qualify for?
If you have since gotten a job or your income has stabilized, but didn’t report this change, your Medicaid health insurance will likely be at risk.
You can still get health insurance and may qualify for a subsidy on the marketplace
Marketplace plans are available to individuals and families who qualify. These plans offer preventative care for free, and don’t hold pre-existing conditions against you.
While coverage may not be exactly the same as Medicaid, you will still get the same benefits such as doctor visits, prescriptions, and coverage for catastrophic events
How to enroll
Working with a broker will help you make a seamless transition from Medicaid to a plan on the Marketplace. You will only have 60 days from the date you are denied Medicaid coverage to find a new plan, so it is important that you find a new plan as soon as possible.
Brokers can help you get comparable coverage to what you have now with Medicaid at an affordable rate. They can assist you with your application and applying for a subsidy if you qualify based on your income.
You will likely also have to get dental and vision coverage because plans on the marketplace do not include this coverage for adults over 18. Children can still benefit from free and reduced costs dental care and vision exams on a plan through the marketplace, but coverage may be limited and may not be as extensive as Medicaid
It should be noted you may have to pay a monthly premium for your new health insurance coverage depending on how much subsidy you get. Plans on the marketplace may offer you more flexibility to see a wider range of doctors, and you will still get access to prescriptions. You will also be able to avoid having a gap in coverage because of this change in legislation.
It is important to make sure that you do not miss any deadlines when making this change because if you do you could be left uninsured.