West Virginians receiving continuous Medicaid coverage was one of the benefits of a pandemic-era law, proving to be a lifeline to children and families and helping to bring down the overall uninsured rate. The provision however is set to expire on April 1, and the regular Medicaid renewal process will resume. Now, even eligible children could lose coverage due to difficulties in the renewal process, like staffing and lack of communication. Please make sure your district's parents are on the lookout for their mailed renewal notices so that they can complete and submit them in a timely manner. Our students cannot afford to lose coverage. I encourage you to invite the Bureau of Medical Services to conduct a webinar for your parents who need this information and may have questions.
What does “unwinding” mean?
“Unwinding” is the process by which states will resume Medicaid eligibility renewals for all enrollees and states will be able to terminate Medicaid enrollment for individuals who are no longer eligible.
How are my healthcare benefits affected?
Individuals enrolled in Medicaid since March 2020 are still enrolled today, and will be at least through April 1, 2023 when the continuous enrollment provision ends. When states resume redeterminations and disenrollments, individuals may be at risk of losing Medicaid coverage or experiencing a gap in coverage, even if they remain eligible for coverage. It is very important to complete and return your renewal form when received to prevent any delays in coverage.
What needs renewed?
The Department of Health and Human Resources (DHHR) will send renewal notices and requests for information to enrollees. When enrollees respond, agencies will process the cases, renew coverage for those who remain eligible, and notify those who are no longer eligible that their coverage will end. If enrollees don’t respond, their coverage will end.
When will Medicaid enrollees begin receiving notifications for renewals?
Enrollees will begin receiving renewal letters in February 2023. Medicaid renewals will be staggered over the next 12 months. Enrollees will receive notices sent to their current mailing address when their renewal is due. Be sure to watch for letters from DHHR and to complete the renewal forms.
What happens when you don’t renew in time?
Failure to complete renewal can result in loss of your healthcare coverage. Under federal law, individuals have 90 days from the date the case was closed to provide the Medicaid agency with all required information, Medicaid benefits can be reinstated without going through the application process if the individual continues to meet the eligibility criteria. If the required documentation is not submitted within the 90 day period to complete the redetermination process, the individual will be required to reapply for Medicaid benefits and a gap in healthcare benefits is likely to occur.
Where can I find more information about the Marketplace?
If you were found ineligible for Medicaid and/or WVCHIP, your application has been sent to the Federally Facilitated Marketplace to be evaluated for healthcare coverage. The Marketplace will be sending you a notice with information about how to apply. If you would like additional information about the Marketplace process or next steps, West Virginia also has a program called WV Navigator that can provide free enrollment assistance in Marketplace health insurance plans. You may contact WV Navigator at (304) 356-5834 or visit the WV Navigator Website.
Contact Information
For more information, please contact the Bureau of Medical Services at 304-558-1700.