Are you or is someone you know currently enrolled in Medicaid, Child Health Plus (CHP), or the Essential Plan (EP)? Did you know that from March 2020 through May 2023, there have been many health insurance flexibilities, including continuous coverage for these types of plans? Basically, the federal government made it easier to maintain public health insurance coverage during the Public Health Emergency (PHE) due to the COVID-19 pandemic. For New Yorkers, this meant the only way to lose your Medicaid, CHP, or EP, was by moving out of state or voluntarily canceling your coverage. In June of this year, one month after the federal PHE ended, this all changed. The months from June 2023 through May 2024 is called the “Unwind” period.i
What is happening during the Unwind? Individuals enrolled in Medicaid, CHP, or EP, have gradually begun to be required to recertify their coverage. Due to the continuous coverage flexibility during the PHE, for some New Yorkers, this will be the first time they have ever had to undergo the recertification process. Individuals with enrollment end dates before May 31, 2023, were the last group to have their coverage automatically renewed for 12 months . Those with later end dates must take action to recertify their coverage – people can have their Medicaid, CHP, or EP coverage discontinued for failure to recertify from July 1, 2023, and moving forward.
How will it work? Those who are currently covered by one of these programs will receive recertification packets in waves according to your annual renewal date. You will receive the packets from the entity you obtain your coverage from. This could be the New York State of Health Marketplace (NYSoH), your county Local District Social Services, or the Human Resources Association (HRA) in NYC. You should receive at least 30 days’ notice before your coverage may be cut off. You also should be aware that regular application rules are back in effect. For example, you can no longer attest to your income.
Additionally, if you are enrolled in the Medicare Savings Program to assist with Medicare costs, those cases are also no longer automatically extended. You should receive recertification forms approximately 2-3 months before they are due. Are you enrolled in QI-1 Medicare Savings Program and live outside NYC? Local District Social Services are sending all upstate QI-1 enrollees full Medicaid applications as QMB and Medicaid income limits have significantly increased.* If you do not fill this out and return (even if you do not want Medicaid), it’s possible you may lose your MSP. If you are unsure what to do, we encourage you to seek legal assistance.
What can you do in the meantime?ii
– Verify your address and contact info is correct
– Pay attention to notices!
– Gather documents to prepare for recertification (proof of income, resources, payment of health insurance premiums, trust documents if applicable)
– Ask for assistance! Empire Justice Center is available to answer your health insurance questions. For those with potential appeals, fair hearings, or other legal questions, we encourage you to reach out for legal assistance as soon as possible.
- Health Law Unit email: health@empirejustice.org
- Health Law Unit Intake Line: 800-724-0490 x5822
*Good news – Medicaid + MSP income limits have increased in 2023! Check out our Fact Sheet for more info.iii