Orlando Harmon
Losing Medicaid coverage can be stressful, but there are several options for staying covered. Firstly, it's important to check if you or your children remain eligible for Medicaid. If not, you can reapply through your state to see if you still qualify. If you no longer qualify, you can consider enrolling in a Marketplace health plan, which offers savings on monthly premiums and covers essential healthcare services. Alternatively, if your employer offers health insurance, you can choose between a job-based plan and Marketplace coverage. Additionally, if you're 65 or older, you may qualify for Medicare, and children may be eligible for the Children's Health Insurance Program (CHIP). It's also recommended to be cautious of misleading marketing and always ensure you're enrolling in a legitimate insurance plan.
| Characteristics | Values |
|---|---|
| If you lose Medicaid coverage | Check if your children remain eligible for Medicaid |
| Re-apply for Medicaid through your state | |
| Sign up for Medicare, if you qualify | |
| Get a Marketplace health plan | |
| Decide between a job-based plan or Marketplace coverage | |
| Check if your state has an Affordable Care Act online marketplace | |
| Check if your state automatically enrolls people who lose Medicaid in marketplace plans | |
| Check if your state has a Children's Health Insurance Program (CHIP) |
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What You'll Learn
Check if you're eligible for Obamacare policies
If you've lost Medicaid coverage, you may be eligible for an Obamacare policy, also known as the Affordable Care Act (ACA) or the Patient Protection and Affordable Care Act (PPACA). The ACA was enacted in 2010 and represents the most significant regulatory overhaul and expansion of coverage in the U.S. healthcare system since 1965.
To be eligible for Obamacare policies, you must be a U.S. citizen or national, or a lawfully present non-citizen in the U.S. Additionally, you must not be incarcerated. If you have Medicare coverage, you are not eligible for a Marketplace health or dental plan. If you are a U.S. "resident" for tax purposes, you are eligible for Marketplace coverage.
It's important to note that some states, like California and Rhode Island, will automatically enrol people who lose Medicaid in Marketplace plans. However, in other states, you may need assistance in navigating the administrative process of finding the right plan. You can get help from a Marketplace assister in your community, but be wary of anyone charging fees for this service or pushing a particular plan. Their services should be free of charge, and you should always confirm their identity before providing any personal information.
You can apply for a Marketplace plan as early as 60 days before your Medicaid coverage ends to avoid a gap in coverage. You can also reapply for Medicaid through your state, as you may still qualify.
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See if your children are eligible for Medicaid
If you are no longer eligible for Medicaid, your children might still be. The Children's Health Insurance Program (CHIP) is a state-federal program that provides free or low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance. CHIP covers children up to the age of 19 and, in some places, households with an income of up to 400% of the federal poverty level (or $120,000 for a family of four) can qualify.
Each state has its own requirements for CHIP, so it is important to check with your state's Medicaid agency to see if your children are eligible. You can find your state's Medicaid agency by searching online. When you apply for CHIP, you may need to provide certain information or documentation, and your state agency will be in touch about enrollment if your child is eligible.
To apply for CHIP, you will need to create an account with the Health Insurance Marketplace and fill out an application. If it looks like anyone in your household qualifies for CHIP, your information will be sent to your state agency, and they will contact you about enrollment. You can apply for CHIP at any time of year, and your state may review your information annually to determine if you are eligible for Medicaid.
To prevent gaps in insurance coverage, some states, such as California and Rhode Island, will automatically enrol people who lose Medicaid in marketplace plans. However, it is important to note that marketplace plans tend to cost more than CHIP and usually do not offer more coverage or benefits.
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Re-apply for Medicaid through your state
If you lose your Medicaid coverage, you can re-apply through your state at any time to see if you still qualify. Each state has its own requirements and application process, so it's important to check with your state's Medicaid agency to understand the specific rules and procedures. You must be a resident of the state where you are applying for benefits.
To apply for Medicaid, you may need to provide certain information or documentation, which can vary depending on your state. Some common items that may be requested include information about your household income, insurance plans offered by your employer, or any current insurance plans you have. It's a good idea to contact your state's Medicaid agency to learn about the specific documentation they require.
Your state may review your information annually to determine your eligibility for Medicaid. They will typically reach out to you if they require additional information to make a decision. Remember that you can always re-apply if your circumstances change, and you may qualify again in the future.
In addition to re-applying for Medicaid, there are other options to consider if you lose your coverage. Many states have expanded their Medicaid programs to cover all individuals below certain income levels, so it's worth checking if your income level qualifies you for these expanded programs. You can also explore the Children's Health Insurance Program (CHIP), which provides coverage for children and, in some states, pregnant women.
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Sign up for Medicare, if you qualify
If you've lost Medicaid coverage, one option to consider is signing up for Medicare if you qualify. Medicare is the US health insurance program for people aged 65 or older, or those with certain disabilities or permanent kidney failure. You can sign up for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) through Social Security. Most people don't pay a premium for Part A, but there is a monthly premium for Part B. If you can't afford the monthly premium, there are programs to help lower your costs.
You can sign up for Medicare starting 3 months before you turn 65, and ending 3 months after the month you turn 65. If you don't sign up when you're first eligible, you may have to pay a monthly penalty for as long as you have Part B. The penalty increases the longer you wait to sign up. If you're already covered by an employer's group health plan, you can delay enrolling in Part B.
If you have Medicaid and are eligible for Medicare, you may be able to get help paying your share of Medicare costs. Contact your state to find out if they can pay your premium for Part A. Depending on the type of Medicaid you have, you may also qualify for assistance with Medicare costs.
It's important to note that Medicare is not the only option for those who have lost Medicaid coverage. Other options include enrolling in a Marketplace health plan, re-applying for Medicaid, or choosing between a job-based plan or Marketplace coverage if your employer offers health insurance.
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Get a Marketplace health plan
If you lose Medicaid or CHIP coverage, you can apply for a Marketplace health plan. The federal government operates the Health Insurance Marketplace, available at HealthCare.gov, for most states. Some states run their own Marketplaces. You can apply and enroll in a Marketplace plan as early as 60 days before your Medicaid or CHIP coverage ends to avoid a gap in coverage. You have 60 days after submitting your application to enroll in a plan, and your coverage starts the month after you complete your enrollment.
Marketplace plans cover things like prescription drugs, doctor visits, urgent care, and hospital visits. Most people qualify for savings to lower what they pay for their monthly premium and when they get care. If you are a member of a federally recognized tribe or an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder, you may be able to get additional cost savings when you enroll in a qualified Marketplace health plan.
If you need help applying for a Marketplace plan, you can contact a Marketplace assister in your community. These assisters are trained and certified by the Marketplace to provide free, fair, and impartial help. They can answer your questions, help you enroll in a plan, and provide information about your health coverage options. Their services are free of charge, and they will never ask you for your credit card number or any other form of payment.
If you have a Marketplace plan and then qualify for Medicaid or CHIP, you should end your Marketplace coverage. If you don't, you may have to pay back some or all of the premium tax credit you received when you file your federal taxes.
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Frequently asked questions
If you lose your Medicaid coverage, you can apply for a Marketplace health plan. You can apply for a Marketplace plan as early as 60 days before your Medicaid coverage ends to avoid a gap in coverage. You can also re-apply for Medicaid through your state to see if you still qualify.
The Health Insurance Marketplace is a federal government-operated service that helps people shop for and enroll in health insurance. The Marketplace is available at HealthCare.gov for most states, while some states run their own Marketplaces.
Even if you are no longer eligible for Medicaid, your children may still be. In every state, children can access these programs with higher household income levels than adults.
