Some Medicaid, CHIP recipients may lose coverage as Pa. resumes eligibility reviews

If you or a family member receive healthcare coverage through Medicaid or the Children’s Health Insurance Program (CHIP), you may soon be affected by changes. Pennsylvania is resuming eligibility reviews for the first time since the COVID-19 pandemic, which means some people will no longer be eligible for these programs. Pam Laye, supervisor of Outreach and Enrollment at Keystone Health, provides information about these changes, and what you need to know to stay covered, in today’s article.

What changes are happening?

For the first time since the pandemic began three years ago, states will once again begin reviewing eligibility for Medicaid and CHIP. On April 1st  2023 Pennsylvania will be able to terminate people who are no longer eligible for these programs.

Pam Laye, supervisor of outreach and enrollment at Keystone Health
Pam Laye, supervisor of outreach and enrollment at Keystone Health

What do people who use these programs need to do?

If you or your child use Medicaid or CHIP, it’s important to make sure your contact information is up-to-date with your local County Assistance Office so they can contact you about any changes. You can do this by calling Pennsylvania’s Statewide Customer Service Center at 1-877-395-8930 or contact your local County Assistance office directly.

If you are a current user of Medicaid or CHIP, you should receive a letter from the state of Pennsylvania which will let you know when you need to complete a renewal form, which will then be reviewed to see if you are still eligible. If you get a renewal form, fill it out and return it right away to help avoid a gap in your coverage. Everyone on Medicaid should receive a packet during the next year, sometime between April 1, 2023 and April 1, 2024. Make sure you reapply if you want to keep receiving the benefits, because those who do not reapply will have their coverage terminated.

What happens if you are no longer eligible for Medicaid or CHIP?

If you complete the renewal and are notified that you are no longer eligible, you will receive notice that your information was forwarded to PENNIE, which is Pennsylvania’s Health Insurance Marketplace. Through PENNIE, you can review your coverage options and the financial assistance that may be available to help pay for this coverage. Children under 19 who are no longer eligible for Medicaid will be directly connected to CHIP.

You can apply for coverage through PENNIE up to 60 days after your Medicaid coverage ends. If you know you are now over the income level for Medicaid eligibility and are going to lose coverage, you can apply for PENNIE up to 60 days before you are scheduled to lose coverage.

Plans with PENNIE are affordable. Four out of five enrollees can find plans that cost less than $10 a month, and these plans cover things like prescriptions, doctor’s office visits, urgent care and hospital visits, and more. When you apply, don’t forget to include current information about your household, income, and your state’s recent decision about your Medicaid or CHIP coverage.

Where can people learn more?

If you have questions, you can contact Keystone Health’s Outreach Enrollment Navigators at 717-709-7969 for free assistance. We will be glad to help you through this process and review your coverage options or address any other questions you have about health insurance or renewals. You can also contact your local County Assistance Office or visit www.Medicaid.gov.

This article originally appeared on Chambersburg Public Opinion: Medicaid, CHIP recipients may lose coverage as Pa. reviews eligibility