During the pandemic health emergency Medicaid’s annual renewal process was stopped. People could not lose their Medicaid coverage even if they no longer qualified. But the health emergency is set to end on April 15th. That means you could lose your Medicaid coverage if you moved, your income increased, or you don’t turn in your renewal paperwork.
Not much has been said about this important pending deadline. If you are one of the 8.7 million adults expected to lose coverage, you probably won’t find out until you are sick and seeking medical care.
Special Enrollment Period
The Biden administration has approved a policy to help avoid that disaster. Qualified individuals can get insurance through the Affordable Care Act (also known as Obamacare) during a Special Enrollment Period (SEP). The SEP will last from March 18th to December 31st.
To be eligible, your household income must be under 150 percent of the federal poverty level ($19,000 for an individual; $40,000 for a family of four). States using the federal marketplace platform must offer the SEP. States using their own marketplace can choose whether or not to offer it. Look up your state here to find out what type of marketplace it uses.
If your state uses its own marketplace, find a link to their site here.
More Help if You Lose Medicaid Coverage
If you qualify for this SEP, you are eligible for a special federal increased subsidy. That means your insurance premium may be zero. But don’t get too comfortable with that. Unless Congress approves an extension or makes the increased subsidy permanent, it’s going away on December 31st.
A Broker Might Not Help You
In response to the SEP, several insurance companies, including Molina Healthcare and some Blue Cross Blue Shield plans, are not going to pay broker commissions during the SEP.
The insurance industry’s trade group says that’s because people who sign up will probably be sicker than the average enrollee. In turn, this will drive up the price of coverage and cost insurance companies more money. And we know the last thing insurance companies want to do is lose money.
You may be like a lot of people who use brokers to help with plan comparison and enrollment. But if insurance companies don’t pay commissions, the brokers aren’t paid. Unfortunately, that means you may be told by brokers that they can’t help you. It’s not because they don’t want to; it’s that like most people, they don’t work for free.
The Centers for Medicare and Medicaid Services (CMS) is looking into this issue. In addition, it’s being challenged by some agents and brokers who say the change is discriminatory.
Where This Leaves Us
If the public health emergency period is extended beyond April 15th, you won’t have to worry about these changes taking place now. But at some point the emergency period will end. Take the time to read any notices you receive about changes to your Medicaid coverage. That may give you time to find other coverage if necessary.
If there is news about the CMS investigation into insurance companies withholding commissions, I will update you here. I will also let you know if the increased federal subsidies for Obamacare are extended beyond December 31st.