Losing Medicaid Coverage

If you are losing Medicaid coverage, you probably have a lot of concerns and questions about how you are going to get health insurance. My name is Jo Hutchison. I'm an independent health and Medicare advisor with Founders Life & Health, and today we are going to be talking about  losing Medicaid coverage, how to navigate that system and what your next steps are.

Losing Medicaid Coverage in 2023

Okay, so how did we get here?

​I can tell you if you are losing Medicaid coverage, you probably really don't care too much about how we got here and the backstory of all of that. And it's probably much more important to you to figure out how to get to the next steps and figure out how to get health coverage. But just quickly, when COVID happened in 2020, Medicaid expanded to cover more people. And in addition to that, a lot of people unfortunately lost their jobs and could no longer afford health insurance through a ACA or no longer had group coverage. So Medicaid was expanded to those people as well. Now that COVID thankfully seems to be less of an issue, or at least no longer a public health crisis like it was in 2020, Medicaid is doing what they're calling winding down Medicaid health coverage. And what that looks like is 91 million Americans are going to have to re-certify to determine if they're still eligible for Medicaid coverage, which is a lot of people. ​

So what does that look like?

What that means is that Medicaid is going to start contacting 91 million Americans to determine:

• If you're still on Medicaid, and you're still alive.
• If you still need Medicaid benefits.
• Most importantly to them, if you still qualify for Medicaid benefits.

​If you are on Medicaid currently, what does that mean for you? It means you are likely going to be contacted by the state that you live in if you currently are on Medicaid or if you have a child that is in the state-based chip program.

The first thing to pay attention to is do they have your correct contact information? You should get into your state-based Medicaid system, make sure that your mailing address is correct and phone number are correct because if they are going to try to get in touch with you, you want to make sure that they can actually reach you.

Secondly, you will want to pay attention to your mail. Something's going to come in the mail, a letter from your state-based Medicaid system that is going to either offer you the opportunity to re-certify your eligibility for Medicaid or it will tell you that you are no longer eligible for Medicaid. If you do get a letter stating that you are no longer eligible for Medicaid, you can contact your state and request to recertify.  If you do choose to try to re-certify, you have 60 days to respond to that letter. You can also choose not to re-certify. If you know that your income is a lot more than it was when you went on Medicaid and you just don't want to even go down the route of trying to re-certify, you can choose not to re-certify.

What's next?

​At this point, if you have either decided not to re-certify for Medicaid, or if you have been determined ineligible to re-certify for Medicaid, what are your options?

First things first, let's look at group coverage. If you are now in a different employment situation, that maybe your employer now does offer group coverage where they didn't before, or if you're in a completely different job that does offer group coverage, let's start there. This will give you very comprehensive coverage. You will get some help from your employer, so we'll offset some of those costs. The best place to start with that is with the HR person at your place of employment.

The HR person at your place of employment can walk you through the process, tell you what the options are, and then you can decide if that is a good fit for you or not. Something to add to that is the family glitch rule could apply to you if the health insurance offered by your employer through their group health plan is too expensive for your dependents. Sometimes employers will offer coverage for the ​employee at the full cost of the employer, but the cost for your spouse or any children or other dependents that you have could be pretty high. In that case, it's a good idea to look at the income ratios and figure out if you qualify for the family glitch rule, which would allow your dependents and your spouse to qualify for ACA.

If group coverage is not an option for you, then the next step is to look at an ACA plan. ACA, Marketplace, Obamacare is all the same thing. I'm going to put a link to a video right here that talks about Obamacare in 2023 and what enrollment in that looks like, but let me cover a little bit more of that right now.
If you are under 65 and now you're at the point where you have either been deemed ineligible to re-certify for Medicaid or you have chosen not to re-certify for Medicaid, then you are going to be in what's called a qualifying life event, which is going to open up a special enrollment period for an ACA plan. You can now enroll in an ACA plan. And depending on your income level and zip code and number of dependents, you may or may not qualify for a subsidy which will offset the cost of that ACA plan.
How do you go about enrolling an ACA plan? Well, there are a couple different ways to do that.

1. ​The first way is to get online, go to healthcare.gov. Fill out all of the information through the prompts. It will ask you for your potential income situation. It will ask you for just some basic demographics and you can determine then if you are eligible for a subsidy and then you can shop plans.
2. Another option is to contact somebody like me. You can reach out to a local insurance agent or insurance advisor in your area. You can also reach out to me directly. Our services are completely free of charge for you. What we do is we help you work through the application, we help you pick out a plan, and then ongoing, we talk to our clients once a year as open enrollment comes up at the end of the year to help them decide if they're currently in the best plan for them or if we need to switch them to another plan.

Something to keep in mind if you do decide to reach out to a health insurance advisor. At Founders, our services are free of charge to our clients. There are some health insurance advisors out there that do charge by the hour. So if you do talk to somebody that can help you through the process, just find out upfront if they are going to charge you an hourly fee to help them or if they are paid by the carriers instead.

Additionally, if you are over 65 and you are going to be losing your Medicaid eligibility, there are still options for you as well.  I would advise also  in that situation, probably even more so, to speak to a health insurance advisor or Medicare advisor to talk about what your options are to supplement your original Medicare.
Even if you lose your Medicaid, you will still have your Medicare if you are over the age of 65. Just for a little understanding as well about the difference between Medicare and Medicaid, I'll put a link to another video right here about the difference between those two.
​You will want to probably supplement your Medicare in some fashion and that can be done either through a Medicare supplement or through a Medicare Advantage plan. A lot of times with the Medicare Advantage plans, you'll also get dental, vision, hearing all included in your plan. So those could be a good option. A lot of times those Medicare Advantage plans have a $0 monthly premium, so reach out to a Medicare advisor about those options as well.

Overall, I just wanted to say there are options. If you are losing your Medicaid, it does not mean you are going to be without health insurance.
There is a way to get coverage, so reach out to somebody in your area, reach out to us, we are happy to help. Again, we are licensed in most states and our services are free of charge for our clients.  Thanks, and I hope this was helpful.

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About the Author

Hello! I’m Jo Hutchison and I’m the owner of Founders Life & Health. I’m a proud baseball mom, lover of live music and all things potato.. My husband and I have two great boys and two lazy hound dogs. My boys play a LOT of baseball so when I’m not helping my clients we can almost always be found on a baseball field somewhere in the Midwest.

I'm a member of NAIFA (National Association of Insurance and Financial Advisors) and a member of NAHU (National Association of Health Underwriters). I spend a good deal of my time working on educational outlets and working on healthcare policy change to help bring comprehensive and AFFORDABLE coverage to everyone. Nothing makes me happier than sharing the tidbits of knowledge that I know about the Medicare and health insurance world so people can make the most informed decisions about what plans they need.

The most important thing that I have learned through the years in this business is that each client has very different needs. Our goal is to listen to you, assess your needs, and use our experience and knowledge to help you make informed decisions about your health care coverage. We are an independent brokerage so we advocate for our clients, not the insurance companies.