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Unwinding of the PHE: DHW Medicaid Protection FAQs 

01-30-2023 01:01 PM

Idaho Department of Health and Welfare (DHW) has released a set of FAQs to help people understand what's going to happen to their Medicaid coverage. This blog is taken directly from DHW. 

What is Medicaid Protection and how does it impact your Medicaid coverage?
Medicaid Protection was put in place at the beginning of the COVID-19 pandemic and provided continued Medicaid coverage for individuals who may have otherwise been ineligible. Congress has recently passed a bill that ends this continued coverage requirement on April 1, 2023. This does not mean Medicaid coverage will automatically end on April 1, 2023 even if you are receiving Medicaid as a result of this special protection.

This does mean the following:

  • When the Idaho Department of Health and Welfare (DHW) determines eligibility for Medicaid for April 2023 and beyond, it will no longer keep ineligible individuals on Medicaid, as Medicaid protection no longer applies.
  • DHW will begin processing re-evaluations of all individuals who are receiving Medicaid coverage under this protection beginning in February. This process will occur in phases every month through fall 2023 for individuals who are on Medicaid Protection.

What happens when Medicaid protection ends? 
Over the next year, DHW will complete a re-evaluation of Medicaid eligibility for all customers who are currently receiving Medicaid. As each group is processed, all customers who receive Medicaid will receive a notice from DHW:

  • If DHW is able to complete re-evaluation automatically, customers will receive a notice of eligibility once that re-evaluation is complete. That notice will contain information about whether they are eligible for Medicaid, as well as details about the information we used to determine your eligibility.
  • Please review this notice and contact DHW if any of the information is inaccurate.
  • If DHW needs a customers participation to complete the reevaluation, they will be sent a notice letting them know that they must contact DHW as it need additional information. Customers may opt to call us or go to idalink.idaho.gov.
  • For individuals who are receiving Medicaid as a result of Medicaid protection, they will also receive a pink notice so that you understand that Medicaid coverage will discontinue if there is no contact. Customers should complete the requested information as soon as they receive it.
  • Households without people receiving Medicaid protection will receive a blue notice letting them know they are not impacted by Medicaid protection ending and will not be required to complete a re-evaluation at this time; however, customers should continue to report any required changes to us.

What if I lose my Medicaid coverage? 
Once Medicaid protection ends, Medicaid will discontinue if you are ineligible. When this happens, customers will receive a notice from DHW that details the customers household’s Medicaid eligibility results. It will also list the information DHW used to determine eligibility. If any of that information is incorrect, contact DHW for a redetermine eligibility for Medicaid. 

If the customer is not eligible for Medicaid, DHW may determine that they may be eligible for a tax credit to help pay for health insurance through Your Health Idaho.  If that occurs, DHW will refer to Your Health Idaho. Your Health Idaho will contact the customer to determine eligibility for the tax credit and how to enroll in health insurance.

What can I do now?
To ensure customers receive notices regarding Medicaid eligibility and re-evaluations, be sure to report any changes to contact information, including mailing address and phone number. If contact information has changed, or to confirm current information, contact DHW using the information below. Customers can also report changes by visiting idalink.idaho.gov.
Phone: 877-456-1233
Email: MyBenefits@dhw.idaho.gov


What are other healthcare options?
Idahoans who are not eligible for Medicaid may purchase health insurance via the state-based insurance marketplace, Your Health Idaho. Coverage can be purchased at Your Health Idaho:
  • Within 60 days of losing Medicaid
  • Anytime during YHI’s Open Enrollment Period.
In addition, if DHW discontinues Medicaid, and determine a customer may be eligible for a tax credit to help pay for health insurance through the state-based exchange, DHW will send a referral to Your Health Idaho, the Idaho state-based health insurance marketplace. Y

Visit yourhealthidaho.org or call 855-944-3246 for more information.

Medicaid Protection FAQ
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