Some important changes to Medicaid will begin in April 2023 and continue for about a year. If you get Medicaid (also called Medical Assistance, or MA), read this article to learn about what you can do to keep your health insurance coverage.
Special Rules During the Beginning of the COVID-19 Pandemic
One of the early pandemic laws from the federal government had a Medicaid continuous coverage rule. This rule said that people on Medicaid could not be disenrolled unless they moved to another state, died, or asked to be removed. This means that you may have not had to report changes or renew your eligibility since 2019 or 2020. This rule applies until April 1, 2023.
The Medicaid Continuous Coverage Rule Is Ending in April 2023 and You Will Need to Update Your Information with MDHHS to Keep Medicaid Coverage
The Medicaid continuous coverage rule will end on April 1, 2023.
Starting from April 1, 2023, the Michigan Department of Health and Human Services (MDHHS) will begin sending renewal information to the addresses they have on file. MDHHS plans to spread the renewals out over a year, so you may not get a renewal letter until 2024.
Renewal packets will go out one to two months before the month they are due. You must respond to this renewal if you get it, or your Medicaid coverage will stop.
How to Make Sure You Keep Healthcare Coverage
Update Your Information with MDHHS
Check Your Mail
After you confirm that MDHHS has your correct contact information, check for renewal information in the mail. Everyone who gets Medicaid will once again be required to go through a redetermination once per year.
Some people will be automatically renewed by an MDHHS process that checks eligibility information automatically using shared government records. Most people will need to complete a yearly renewal form. Complete and send back any renewal forms you get right away. You can also complete the process online by filling out the forms and uploading any requested verification at MI Bridges.
Steps You Can Take if You Lose Medicaid Coverage
If you get a notice from MDHHS that your Medicaid will end or if you find out from a healthcare provider that your coverage has ended, you may want to speak to a lawyer. Use the Guide to Legal Help to find a legal services office near you. If you cannot get help from legal services or if you are close to any deadlines, you may also want to take some steps on your own to protect your health care coverage.
If MDHHS ends your Medicaid coverage and you believe this was incorrect, you can appeal by asking for a hearing. There are many different kinds of Medicaid coverage and some have different eligibility requirements. MDHHS must consider each family member’s eligibility for other Medicaid programs before terminating them. If you believe you or a family member should be eligible under a new category you can appeal.
You should request a hearing before the effective action date listed on the notice. The effective action date for Medicaid is always on the first of the month. If you do this, federal law requires that your coverage continue while waiting for the hearing. Even if the effective action date has passed, you can still appeal as long as MDHHS receives your hearing request form within 90 days from the date on the letter.
If the effective date listed in the notice has already passed when you appeal, MDHHS is allowed to stop coverage while they decide the appeal. If you are in this situation, you may want to reapply at the same time that you request a hearing in case that might turn coverage back on faster. Read the section below to learn more about how to reapply.
You can use the Do-It-Yourself MDHHS Hearing Request to help you fill out the form. Make a copy of the form to keep for your records. You can fax, mail, or drop off your request in person. If you fax your request, keep the fax confirmation for your records. If you choose to mail your request, you may want to send it by certified mail to have proof of when you sent it. Be sure to direct it to the Hearing Coordinator, not your caseworker.
If you drop off your request, sign the log book in the office lobby (if available). If you have a camera phone, take a picture of your signature in the log book for your records. You could also ask the person who takes the form to stamp your copy as proof of when you dropped it off.
An old MDHHS policy required Medicaid hearing requests to be received by MDHHS within 10 days of the notice date. MDHHS changed this policy but has not fixed its computer system. This means people getting Medicaid still get notices that require their hearing requests be received in 10 days. If you have had an issue related to this, contact your local legal services office for help. Use the Guide to Legal Help to get their contact information.
Search for Affordable Marketplace Coverage, If Needed
You might be removed from the Medicaid program because you are not eligible for Medicaid anymore. If you agree with this decision, or if you file an appeal and lose, you will need to look for other medical insurance coverage.
One option is to buy coverage on the Health Insurance Marketplace by going to healthcare.gov. According to the Centers for Medicare and Medicaid Services, 4 out of 5 people who enrolled using the Marketplace found coverage for less than $10 per month. All insurance plans on the Marketplace cover prescription drugs, doctor visits, urgent care visits, hospital visits, and more.
Typically there is a yearly enrollment period and you can’t enroll outside of this period unless you have a qualifying event. Losing Medicaid coverage is a qualifying event. If you lose Medicaid coverage, you can buy insurance on the Marketplace even outside of the usual enrollment period.
Updated January 3, 2023.