Medicaid Unwinding in Illinois: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Illinois are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This is being called the unwinding of Medicaid, and some people will lose coverage during this process.
During the PHE, Medicaid renewals were automatic, and enrollees had continuous coverage. As part of the unwinding process, automatic renewals for Medicaid stopped nationwide on March 31, 2023. In Illinois, this applies to the state’s Medicaid program — known as Medical Assistance — and All Kids, which is the state’s name for its Children’s Health Insurance Program.
The Illinois Department of Human Services, which oversees Medical Assistance and All Kids, has started reviewing eligibility for enrollees. Make sure IDHS has your current contact information. If the agency can’t reach you, or if you’re no longer eligible for coverage, you could lose coverage as early as July 1, 2023.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. The PHE was renewed a dozen times by February 2023.
People who were eligible for Medicaid during the PHE were able to keep their coverage, even if they no longer qualified. This is because all states — including Illinois — were required to provide continuous coverage during the PHE.
But the PHE ended on May 11, 2023, and most COVID provisions, including automatic Medicaid renewals, stopped nationwide in March. Over the next year, 8 million to 24 million enrollees nationwide could lose Medicaid coverage.
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Illinois has resumed eligibility reviews for the state’s Medicaid program, known as Medical Assistance, and for its Children’s Health Insurance Program (CHIP), known as All Kids. This is called the redetermination process. Anyone who no longer qualifies could lose coverage as early as July 1, 2023. In fact, as many as 700,000 people in the state could lose Medicaid or CHIP coverage.
Here’s what you need to know about Medicaid changes in Illinois, and what to do if you lose your insurance coverage.
Why is Medicaid changing nationwide?
After the PHE ends, COVID-19 will remain a public health priority — just not an emergency. As part of this process, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid.
The unwinding will affect Medicaid in every state, Washington, D.C., and five U.S. territories.
What’s happening with Medicaid renewal in Illinois?
The Illinois Department of Human Services (IDHS) is responsible for overseeing the state’s Medicaid program. IDHS has a redetermination plan that outlines how the state will conduct eligibility reviews for current enrollees over the next year.
It’s important for you to confirm or update your contact information with IDHS. You can do so by:
Visiting the Application for Benefits Eligibility (ABE) self-service portal and clicking on “Manage My Case” to log into your account
Using the Medicaid change of address form to update your mailing address and opt into email and text alerts, if you wish
Calling the IDHS helpline at 1-800-843-6154
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What to expect during the renewal process
Your renewal date will be available about a month before your renewal is due. You can find your renewal date online by visiting the ABE self-service portal. Click on “Manage My Case” to log into your account. Your due date is in your “Benefits Details” tab. You can also call 1-800-843-6154 to check your renewal date by phone if you have your Recipient Identification Number (RIN).
The state already has enough eligibility information from other programs to renew some people’s coverage automatically. If that applies to you, you will receive a Form A notice confirming your coverage for the next year.
If more information is needed, you will receive a redetermination letter, known as Form B, in the mail. When it’s time to renew your benefits, you can visit the online portal. You will see a “Renew My Benefits” button on your “Case Summary” page.
If you miss your renewal due date, you are still encouraged to send in your information — even though it’s late. If this happens, you may receive a letter stating your last day of coverage, but if you still qualify for Medicaid, there is a chance you can have your coverage restarted if you submit your renewal within 90 days of the date your coverage is scheduled to end. Each case will be reviewed individually.
If your case is terminated then reinstated, your coverage will be retroactive to the date you lost coverage.
If you submit your renewal more than 90 days late, you will have to reapply for Medicaid with a new application.
Those no longer eligible for Illinois Medicaid will receive a letter with the following information:
Coverage end date
Instructions for appealing the decision
Options for purchasing other health care coverage, such as a plan on the Get Covered Illinois marketplace
If you need to reach Illinois Medicaid by phone, call the IDHS helpline at 1-800-843-6154. If you don’t speak English or Spanish, the representative will access a live interpreter for translation.
What should I do if I lose my Medicaid coverage in Illinois?
In order to receive Medicaid in Illinois, you must meet all of the following criteria:
You must be an Illinois resident.
You must be a U.S. citizen, permanent resident, or legal resident.
You must need assistance with access to healthcare or insurance coverage.
Your annual household income before taxes are withheld must be below the limit for your household size.
In Illinois, you may also qualify for reasons other than income, including if you are:
Pregnant
A child or teenager
Responsible for the care of a child who is 18 years old or younger
Blind
65 years old or older (and meet certain criteria)
A person with a disability, or you have a person in your household who has a qualifying disability
A former foster child
In need of nursing home care
Age 19 and older with family planning needs
In need of treatment for breast or cervical cancer (and have been screened or are still undergoing treatment)
If you no longer qualify, or if IDHS can’t reach you, you will no longer be able to use your benefits, which could leave you temporarily uninsured.
If you lose your coverage but believe you still qualify, you can reapply for Medicaid. You may be uninsured for a while until you’re approved for coverage again.
If you choose not to reapply for Medicaid coverage, or if you’re no longer eligible, you may qualify for other low-cost or free healthcare options. You can also use GoodRx coupons to save on your prescription medications. In addition, you may be able to enroll in an alternative health insurance plan such as:
Affordable Care Act (ACA) marketplace plan: You may be able to find a plan on Get Covered Illinois, the state’s ACA platform. If you qualify for a premium subsidy, you may be able to get an ACA plan for $10 or less per month. If you lose Medicaid, you can purchase an ACA plan during the unwinding special enrollment period from March 31, 2023 to July 31, 2024.
Employer plan: Your company may offer employer-sponsored health insurance.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, will be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA) benefits: If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Illinois Medicaid resources
Here are some resources to help you learn more about Medicaid in Illinois and upcoming changes related to Medicaid unwinding:
Illinois Medicaid office: The Illinois Department of Human Services (IDHS) oversees and administers the state’s Medicaid program.
Illinois Medicaid contact information changes: To confirm or update your contact information with IDHS, you can use the Medicaid change of address form. To do this, visit the ABE self-service portal and click on “Manage My Case,” or call the IDHS helpline at 1-800-843-6154.
Illinois Medicaid digital alerts: In addition to updating your mailing address, you can opt into email and text alerts by completing the Medicaid change of address form.
Illinois Medicaid FAQs: Find answers to frequently asked questions about the Medicaid unwinding in Illinois.
Illinois Medicaid phone assistance: You can call the IDHS helpline at 1-800-843-6154.
The bottom line
Automatic Medicaid renewals stopped on March 31, 2023, in advance of the COVID-19 public health emergency’s conclusion on May 11, 2023.
The Illinois Department of Human Services (IDHS) will be reviewing case eligibility over the next year. Some Illinois Medicaid enrollees could lose coverage as early as July 1, 2023. In some cases, the IDHS has enough information to renew your Medicaid without asking you to submit a renewal application. If this doesn’t apply to you, you will receive a renewal letter in the mail. You can complete your renewal form or renew through the ABE self-service portal.
It’s important that the IDHS has your up-to-date contact information — especially your current mailing address. You can update your information online through the ABE self-service portal, by phone, or via the Medicaid change of address form.
If you lose Medicaid coverage, you may be eligible for an Affordable Care Act plan through the Get Covered Illinois marketplace.
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References
Administration for Strategic Preparedness & Response. (2023). Renewal of determination that a public health emergency exists.
Administration for Strategic Preparedness & Response. (2020). Determination that a public health emergency exists.
Alpasan, E. (2023). 700,000 Illinoisans at risk of losing Medicaid coverage: How to prepare for eligibility checks, navigate health care resources. WWTW.
Centers for Medicare & Medicaid Services. (2023). Temporary special enrollment period (SEP) for consumers losing Medicaid or the Children’s Health Insurance Program (CHIP) coverage due to unwinding of the Medicaid continuous enrollment condition – Frequently asked questions (FAQ).
Illinois Department of Healthcare and Family Services. (2023). Continuous coverage ends 3/31/2023 and medical redeterminations resume.
Illinois Department of Healthcare and Family Services. (2023). Illinois Medicaid and the end of continuous coverage FAQ.
Illinois Department of Healthcare and Family Services. (2022). Healthcare for kids.
Illinois Department of Human Services. (n.d.). Medical assistance programs.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
