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The state of emergency declared nation-wide due to COVID-19 led to the creation of public health policies that aimed to protect citizens from the health contingency. The laws included continuous Medicaid coverage under which beneficiaries were guaranteed uninterrupted coverage, with no need for an annual redetermination on the basis of changes in their household or their income.
Upon the end of the state of emergency, the government intends to return to the Medicaid eligibility review and recertification processes. Starting on April 1st, the North Carolina Health and Human Services Department will initiate this process by sending renewal information to each of its beneficiaries.
Many individuals covered by the “Continuous Enrollment” for Medicaid and CHIP will receive eligibility denial letters. It is estimated that Medicaid recertifications will have a negative impact on more than 300,000 people in North Carolina, while 5 to 14 million people nation-wide will lose their health coverage by the end of the redetermination process.
The Kaiser Foundation estimates that this process will excessively affect those individuals who have moved away since the pandemic, as well as individuals with limited English proficiency and disabled communities. This is due to the barriers that the most vulnerable face to have access to the renewal process.
Risks
Having moved since 2020: Those who changed their address might not receive urgent information.
Not speaking English: Language barriers might prevent many individuals from advocating for their rights.
Low literacy or knowledge on how to manage processes.
Having turned 19 years old during the pandemic: Those who were eligible will be excluded from the CHIP program upon reaching the maximum age.
It is important to be prepared to avoid a Medicaid or CHIP coverage interruption. Make sure to:
- Update your contact information with your local Medicaid’s office (you may call 888-245-0179 or update your information if your ePASS account).
- Check for letters in the mail.
- Make sure to fill out the renewal form if you get one.
- If you receive a letter requesting additional information about your income or changes in your household, it is important that you complete it as soon as possible. You have 90 days to submit these documents.
If Medicaid services are denied, it is important to know your rights; you will have 60 days to process an appeal. You have the right to be your own representative, additionally, your letter will contain contact details for an attorney who may provide you with free assistance and services in your language.
Those individuals who are no longer eligible for Medicaid may have access to purchase health insurance through the Health Insurance Marketplace and to get assistance with its costs through federal financial assistance. The denial letter will provide the link to the Health Insurance Marketplace website: healthcare.gov. You will be given a “Special Enrollment Period” (SEP), due to the termination of the Continuous Enrollment for Medicaid and CHIP; this period starts on March 31st, 2023 and will continue until July 31st, 2024. Those consumers who are eligible for SEP will have 60 days from the date when their application is submitted to the Health Insurance Marketplace to select a health plan.
The NC Navigator Consortium support network, led by Legal Aid North Carolina, offers services to help people in transitioning to the Healthcare Marketplace at local level. As part of the support network, the United Language Navigators program is specifically focused on communities with limited English proficiency.
At the ULG Community Navigators program, we can help you with the enrollment process, checking with you the amount of financial assistance that may be provided by the government and examining the different insurance options offered by the Marketplace, so that you can make the most appropriate decision based on its scope and your needs. You can call us from Monday to Friday at 866-960-1926 if you have any questions about this process. We are a non-profit program funded by the Medicare and Medicaid Services Center to assist the community in our language and we are here to help you.
United Language Community Navigator Program:
Phone: 1-866-960-1926
Website: https://ulgnavigators.com/
