Medicaid Unwinding in Indiana: What You Need to Know If You Lose Coverage
Key takeaways:
The COVID-19 public health emergency (PHE) is ending on May 11, 2023. As a result, everyone receiving Medicaid benefits will have their cases evaluated for eligibility. Some people may lose coverage. This evaluation period is called the unwinding.
During the PHE, Medicaid renewals were automatic, and people enrolled in Medicaid had continuous coverage. As part of the unwinding, automatic renewals for Medicaid and the Children’s Health Insurance Program (CHIP or Children’s Medicaid) stopped nationwide on March 31, 2023.
The Indiana Family and Social Services Administration is working to determine who is still eligible for Medicaid. Make sure they have your current contact information. If you no longer qualify for Medicaid, you could be dropped from coverage after your annual renewal date. This could happen as early as May 1, 2023.
If you lose your Medicaid coverage during the unwinding period, you will be offered alternative low-cost health insurance options, like the plans on the Affordable Care Act marketplace.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January of 2020. The PHE was renewed a dozen times through February 2023. While it was active, everyone who was enrolled in Medicaid kept their health insurance without needing to undergo eligibility reviews.
The PHE will end on May 11, 2023, and automatic Medicaid renewals stopped on March 31, 2023 during a process called the unwinding. As a result, an estimated 375,000 to 500,000 people in Indiana could lose coverage from Medicaid or the Children’s Health Insurance Program (CHIP or Children’s Medicaid).
The Indiana Family and Social Services Administration oversees Indiana Medicaid programs. Officials have started eligibility reviews for Medicaid and CHIP enrollees. This post-pandemic evaluation process is known as redetermination. If you or your family members are no longer eligible for Medicaid, you could lose coverage as early as May 1, 2023.
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Here’s how to navigate the upcoming Medicaid changes in Indiana and what to do if you lose your benefits during the unwinding.
Why is Medicaid changing nationwide?
Once the PHE ends, COVID-19 will no longer be considered an emergency. When that happens, emergency measures like automatic Medicaid renewals will no longer be enforced. The unwinding is going to affect people in all 50 states, the District of Columbia, and 5 U.S. territories. Millions of people nationwide are at risk of losing their Medicaid coverage.
What’s happening with Medicaid renewal in Indiana?
The Indiana Family and Social Services Administration (FSSA) is the office responsible for overseeing Indiana Medicaid, which provides healthcare access for more than 2 million people. Officials have put together a redetermination plan that explains what the state will do during its 12-month unwinding period that starts in April 2023. The unwinding in Indiana is expected to be completed by May 2024.
FSSA plans to evaluate 8% to 11% of Medicaid cases every month for a year. Reviews will occur in the month of your initial Medicaid approval or the month of your last annual redetermination.
FSSA officials predict that 375,000 to 500,000 Indiana residents will not have their Medicaid or CHIP renewed. Some individuals will lose coverage because they have household incomes that are higher than when they became eligible. Others will be dropped because the FSSA cannot reach them to verify their eligibility.
The state has enough “recent and reliable” information for about 75% of enrollees to auto-renew coverage without taking action, if the information is correct. These individuals include people who:
Receive Supplemental Security Income (SSI)
Are pregnant
Are in the 12-month postpartum period
Are receiving adoption assistance
Are foster children younger than 26 years old
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People in this category could be disenrolled, however, if information such as income has changed.
About 500,000 will need to take action and provide information to FSSA to have their eligibility renewed. If you aren’t auto-renewed, you should receive a letter in a white envelope with the FSSA logo that reads “ATTENTION NEEDED” in red to notify you that the state will be requesting information.
Your redetermination packet will be mailed 45 days before the due date. View this YouTube video to learn how to upload your documents to the benefits portal.
Make sure your contact information is up to date
It’s important for the FSSA to have your current contact information during the unwinding. You can update your information in the FSSA benefits portal.
There are several ways FSSA may try to contact you during the unwinding:
You could receive a letter in the mail.
You can receive information via email, if you have signed up for email notifications.
You may receive text messages from 468311.
You may receive push notifications from the Indiana Managed Health Services (MHS) app if you have this downloaded on your device.
Requests for paperwork like proof of income will be visible in your account in the FSSA benefits portal.
If FSSA is unable to contact you, you could lose your benefits. If you don’t respond, you may have another 90 days to provide the information and could potentially regain coverage.
If you need to reach FSSA by phone, call 800-403-0864.
What should I do if I lose my Medicaid coverage in Indiana?
You are eligible for Medicaid in Indiana if you currently meet all of these requirements:
You are an Indiana resident.
You are a U.S. citizen or permanent or legal resident.
You currently need insurance assistance.
Your household’s annual income falls at or below the state’s yearly income threshold.
And you are one of the following:
Currently pregnant
Responsible for the care of a child who is 18 years old or younger
Blind
65 years old or older (and meet certain conditions)
Person with a disability, or a member of your household has a qualifying disability
If you no longer meet Indiana’s Medicaid eligibility guidelines, your benefits will not be renewed. You should receive a notification at least 13 days before your coverage ends.
If you lose coverage, your application will be automatically transferred to another government healthcare program for consideration. This may include plans like those offered on the Affordable Care Act exchange. You can also check your account in the FSSA benefits portal to see updates on your status.
Some people will lose Medicaid coverage even though they actually qualify. This could be because the FSSA was unable to contact them, or because the state could not verify their eligibility. If you lose your Medicaid benefits but believe that you still qualify, you can reapply for Medicaid in Indiana.
The re-approval process takes time, and you might be uninsured while you wait. If that happens, consider these free and low-cost healthcare options. You can also use free GoodRx coupons to save money on your prescription medications.
If you do not want to reapply for Medicaid, you can try to get coverage elsewhere. Depending on your circumstances, you may qualify for a different government healthcare program. You may also find health insurance through one of these options:
Affordable Care Act marketplace: Plans on the Affordable Care Act (ACA) exchange start as low as $10 or less per month if you qualify for a premium subsidy. Everyone who has their Medicaid benefits terminated during the unwinding can participate in a special enrollment period from March 31, 2023 to July 31, 2024. During this time, you can choose a new insurance plan on the ACA marketplace.
Employer plan: If you are currently working, check with your job to see if they offer health insurance.
Medicare: Some disabilities and conditions like end-stage renal disease or ALS (amyotrophic lateral sclerosis) qualify you to enroll in Medicare at any age.
Partner’s plan: If your spouse or domestic partner has insurance, they may be able to add you to their plan during the next open enrollment period.
Special plans: Options like short-term insurance can cover you temporarily if you know you will have something like job-based health insurance available in the near future. You could also consider some alternative and limited-benefit plans, like indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you are currently a student who is enrolled in a college or university, you may be able to enroll in your campus health plan.
U.S. Department of Veterans Affairs (VA): Active-duty service members and veterans may qualify for TRICARE coverage or VA benefits and services.
Indiana Medicaid resources
Here are some sites where you can learn more about Medicaid in Indiana and upcoming changes related to the end of the public health emergency:
Indiana Medicaid office: Find general information through the Indiana Family and Social Services Administration, which oversees Medicaid programs in Indiana.
Indiana Medicaid self-service portal: Log in to your Medicaid account 24/7 through the FSSA benefits portal to learn more about Medicaid and CHIP renewal as well as to update your contact information.
Indiana Medicaid redetermination: Get information on the Indiana Medicaid redetermination plan, including the timeline of changes.
Email notifications: Learn how to receive your Indiana Medicaid notifications via email.
Medicaid application or renewal help: Find a certified healthcare navigator in your county. Assistance is available in English and Spanish.
Indiana Medicaid unwinding Q&A: Get answers to frequently asked questions about the end of continuous Medicaid coverage.
The bottom line
Automatic Medicaid renewals ended nationwide on March 31, 2023. This is because the COVID-19 public health emergency is winding down. During this process, an estimated 375,000 to 500,000 people in Indiana could lose coverage.
The Indiana Family and Social Services Administration (FSSA) will be reviewing Medicaid cases for eligibility from April 2023 to April 2024. Your renewal date will be the month of your initial Medicaid approval or the month of your last annual redetermination.
FSSA officials predict that most cases will be renewed without people having to provide additional information. If not, the state will try to reach you by mail, text message, or through the FSSA benefits portal.
It’s important to update your contact information in the Indiana FSSA benefits portal. Otherwise, you may not receive your notifications and could lose your benefits. If you do lose your Medicaid coverage, you can reapply if you still qualify. If you are not eligible, there are low-cost options available, including those on the ACA marketplace or Medicare.
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References
Carden, D. (2023). Indiana to begin dropping ineligible Medicaid members April 30. The Times.
Centers for Medicare & Medicaid Services. (2023). Unwinding and returning to regular operations after COVID-19.
Indiana Family and Social Services Administration. (2023) DFR. [Video]. YouTube.
Indiana Family and Social Services Administration. (2023). Medicaid eligibility review actions.
Indiana Medicaid for Members. (2023). Email notifications.
Indiana Medicaid for Members. (2023). How a return to normal will impact some Indiana Medicaid members.
Indiana Medicaid for Members. (2023). Medicaid coverage protections Q&A’s.
Indiana Medicaid for Members. (2023). State report on plans for prioritizing and distributing renewals following the end of the Medicaid continuous enrollment provisions.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Administration for Strategic Preparedness & Response. (2020). Determination that a public health emergency exists.
U.S. Administration for Strategic Preparedness & Response. (2023). Renewal of determination that a public health emergency exists.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
