Special Enrollment Period For Those Affected By Medicaid Unwinding: Is Losing Medicaid A Qualifying Event?
The Gist
The Medicaid redetermination process is underway, which means your state is going to check to see if you’re still eligible for the program. If you’re no longer eligible, your Medicaid coverage could end any time between now and July 2024.
Is losing Medicaid a qualifying event? Anyone facing a loss in Medicaid coverage over the next year can apply for a special enrollment period, which will allow them to select a new health plan outside of the regular open enrollment session.
If you lose Medicaid coverage, don't worry! You can apply for that special enrollment period and a new affordable health plan at the same time with Stride. Stride will find the right plan for your unique needs in minutes, then help you enroll from start to finish so you don’t have a gap in coverage.
In This Article
How Do I Avoid Losing Coverage With A Special Enrollment Period?
How Do I Apply for a Special Enrollment Period If I Lose Medicaid?
How And When Will I Be Notified If I’m Losing My Medicaid Coverage?
In Short
Perhaps you’ve heard the phrase “Medicaid redetermination” often recently. This is the process by which your state checks whether or not you still qualify for Medicaid coverage. And if they decide you’re no longer eligible, you’ll lose that coverage.
The redetermination process — which is sometimes also referred to as Medicaid unwinding — normally happens annually. But the government took a break for the last three years to ensure everyone had continual access to health care during the pandemic. Now, though, it’s restarting, and you’re most at risk of losing your coverage if:
Your income increased
You were unemployed, but now have a job
You moved sometime in the last three years
Your state isn’t able to contact you (for example, this might be the case if you changed addresses and didn’t notify the Medicaid office)
Don’t Stress. We’re Here For You!
The potential of losing Medicaid can feel overwhelming. But don’t worry — even if you lose your coverage, you have options. One of those options is a Medicaid special enrollment period, which gives you the opportunity to enroll in a new health insurance plan in time for your loss of Medicaid coverage.
We’re here to tell you everything you need to know about the Medicaid special enrollment period. That way, if you do lose your Medicaid coverage, you’ll have an affordable new plan to fall back on.
What Is a Special Enrollment Period?
A special enrollment period is the time during which you can apply for new health coverage, so long as you experience a qualifying life event. Losing your Medicaid coverage is considered a qualifying event. Other common ones include:
Losing job-based coverage
Moving
Getting married or divorced
Having or adopting a baby
A special enrollment period differs from the annual open enrollment period, which starts on November 1 and is when anyone can get new health insurance for any reason.
Avoid Losing Coverage With a Special Enrollment Period
It is no secret that many private health plans can be expensive — but not having insurance coverage at all can be costly beyond measure. If something were to happen while you’re uninsured due to Medicaid unwinding, you may rack up steep medical bills that could be hard to financially recover from.
While the number of people without health care coverage has been at an all-time low over the past two years, there are fears that this number will only increase as special Medicaid enrollments unwind.
Good news — there are lots of affordable plans to pick from! In fact, 4 out of 5 people can find a plan for less than $10 a month. This is in part due to subsidies that can lower the cost of your plan. For instance, if your income is within a certain range, you qualify for the premium tax credit, which lowers your monthly health insurance payment.
When Is the Special Enrollment Period If I Lose Medicaid and How Long Do I Have to Find New Coverage?
The short answer: The exact dates depend on where you live and when you lose your coverage.
But in general, you can apply for new coverage and a low income special enrollment period as soon as your state alerts you that you’re no longer eligible for Medicaid (that’s right — you don’t have to wait until your Medicaid expires to get started).
For reference, your Medicaid coverage will end about 60 days from the date of your notice (or as otherwise indicated by your state). If you are within 60 days of losing your coverage, you can apply for new coverage and a low income special enrollment period at the same time. If you are losing Medicaid coverage farther in the future, you have until 60 days after your Medicaid coverage ends to select a plan, though we encourage you to select a plan as soon as possible to avoid a gap in coverage.
How Do I Apply for a Special Enrollment Period If I Lose Medicaid?
First things first, your state will alert you if you’re losing your Medicaid coverage (pro tip: make sure the contact information you provided your state’s Medicaid office is up-to-date to ensure you receive these alerts!).
If you are losing Medicaid, Stride makes it easy to apply for both a special enrollment period and new coverage all at once. Here’s what to expect:
You’ll answer a few quick questions about yourself (like your age, location, health concerns, and preferred doctors and prescriptions).
Stride will show you the top plans that match your needs.
Browse the plans and pick your favorite.
Follow Stride’s instructions to enroll, including providing proof of loss of Medicaid coverage (this will ensure you qualify for the special enrollment period). If you need help, our experts can assist you when it comes to enrolling in your new health plan.
What Does Medicaid Unwinding Mean?
Current Medicaid members may lose their eligibility as soon as April 1. This means there could be a loss of coverage for anywhere between five and 14 million Americans, including those who are unenrolled and then reenroll later on.
Since the start of the pandemic in 2020, the federal government has made it a lot easier for people to apply and be eligible for Medicaid coverage. In fact, they even issued a Public Health Emergency with orders that required states to automatically reenroll everyone in Medicaid every year — regardless of their changing eligibility status. Known as the Continuous Enrollment Condition Provisions, these orders made it possible for people to continue using their Medicaid plans without having to worry about reapplying.
But in 2023, the Center for Medicare and Medicaid Services (CMS) released an Informational Bulletin announcing that this policy will be ending. The unwinding period is expected to last 12 months, which gives those affected plenty of time to find a new plan if they are no longer eligible for Medicaid.
What Does This Mean for Your Medicaid Coverage?
You may be at risk for unenrollment during the next Medicaid eligibility period depending on:
Income status
Age
Job status
A change in your address or contact information (for example, this might be the case if you changed addresses and didn’t notify the Medicaid office)
How And When Will I Be Notified If I’m Losing My Medicaid Coverage?
Your state will contact you via mail and again by either email, text, or a phone call. Remember — make sure your contact information is up-to-date so you don’t miss any of these alerts.
You’ll get this notification between April 1, 2023 and May 31, 2024. If you’re not able to renew your Medicaid, your coverage will end about 60 days after you get that notice. But don’t be alarmed, Stride is here to help you find a new plan if you lose Medicaid coverage.
If you need help finding and enrolling in new coverage contact our experts for one-on-one guidance in English or Spanish at 415-915-2156, support@stridehealth.com, or via chat.
