What to do if you lose Medicaid
Millions will in months to come; help finding a new plan is available
Medicaid coverage will end for millions of Americans in the coming months, and it will push many into unfamiliar territory: the health insurance marketplace.
Shopping for affordable insurance that covers regular doctors and prescriptions can be daunting, especially in marketplaces that offer dozens of choices and subsidies to help pay for them. Here’s a deeper look at the process.
What’s happening to Medicaid?
Nearly 85 million people are covered by governmentfunded Medicaid, which focuses on people with low incomes.
At the start of the pandemic, the federal government prohibited states from kicking people off Medicaid if they were no longer eligible. That ban ends this spring, and many people on Medicaid will be introduced to this so-called redetermination process for the first time.
Most states will start ending coverage for ineligible people in May, June and July.
Federal officials estimate over 8 million people will lose eligibility and leave Medicaid mainly because their incomes have changed.
Where to get new coverage
State-based health insurance marketplaces created by the Affordable Care Act are the only places where people can buy individual insurance with help from an income-based subsidy.
They can be found through the federal government’s healthcare.gov website.
Income-based subsidies
The cost of any new plan should be one of the first things people consider. Shoppers can get income-based subsidies to help pay monthly premiums of plans they buy on the state-based marketplaces. Those subsidies were enhanced during the pandemic.
If you’re on Medicaid
Make sure your state program has your current contact information, including mailing and email addresses and a cellphone number. They will send notifications if they need more information or if someone no longer qualifies for Medicaid.
“Everyone should do that before April,” said Joshua Brooker, a broker based in Lancaster, Pa. “It’s going to make a smoother transition.”
Start shopping for new insurance before Medicaid ends. The goal should be to have new insurance that starts the day after Medicaid ends.
Getting help
Seeking assistance may be a good idea, especially for people who need help figuring out their income for the coming year. That’s needed to calculate subsidies.
There are several ways people can get help.
State marketplaces have navigators who can help people sort through options and understand potential plans. The government-funded navigators are free to use but they cannot recommend specific choices.
Federally qualified health centers also have counselors who can help people apply.
Independent brokers also help people sort through options. They will get a fee that usually comes out of the premium you wind up paying.