Medicaid Unwinding in Missouri: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Missouri 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 and the Children’s Health Insurance Program (CHIP) stopped nationwide on March 31, 2023.
If you lose Medicaid coverage during the unwinding process, you may qualify for an alternative low-cost health insurance option, such as an Affordable Care Act (ACA) marketplace plan.
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 through February 2023.
People who qualified for Medicaid during the COVID PHE were able to keep their coverage throughout the pandemic without having their eligibility reviewed. This is because all states, including Missouri, were required to provide continuous coverage during the PHE.
But the PHE ended on May 11, 2023. And that marked the end of most COVID provisions, like automatic Medicaid renewals, which stopped nationwide in March. These changes could cause 8 million to 24 million Medicaid enrollees across the country to lose coverage.
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Missouri has resumed eligibility reviews for Medicaid and Children’s Health Insurance Program (CHIP) enrollees. As part of this redetermination process, some residents who no longer qualify could be disenrolled as early as July 1, 2023. By the end of this process, the Missouri Department of Social Services (DSS) estimates that about 200,000 people in the state could lose Medicaid or CHIP coverage.
Here’s what you need to know about Medicaid changes in Missouri, and what to do if you lose your insurance coverage.
Why is Medicaid changing nationwide?
Now that the PHE has come to an end, COVID 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 Missouri?
The Missouri DSS is responsible for overseeing the state’s Medicaid program, which is called MO HealthNet. You can read about the renewal process and the state’s unwinding plan on the DSS website. The agency has included information about how the state plans to handle eligibility reviews for more than 1.4 million enrollees, which will be conducted by Missouri’s Family Support Division (FSD).
Missouri’s redetermination process started in April, when the state began to review cases with June renewal dates. So some residents could lose their coverage as early as July 1.
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If you or a household member is enrolled in MO HealthNet, it’s important for you to confirm or update your household’s contact information with the FSD. You can confirm or update your information by:
Logging in to your account on the FSD benefits portal
Calling the FSD information line at 1-855-373-4636
Visiting your local FSD resource center
If you qualify for Medicaid but the FSD can’t reach you when it’s time to renew, you could lose your coverage for procedural reasons.
What to expect during the renewal process
Every MO HealthNet enrollee will receive a letter from the FSD sometime between April 2023 and April 2024 — at least a month before their renewal is due. The unwinding renewal timeline affects cases with renewal months from June 2023 to May 2024.
The state already has enough eligibility information from other programs to renew some enrollees automatically. If you are part of this group, you will receive a letter stating that you do not need to take action and that your coverage has been renewed. If more information is needed, you will receive a renewal packet.
This yellow, pre-populated renewal packet will arrive at least one month before the additional information is due. You can submit this information and complete your Medicaid renewal in a few different ways:
Online: Visit the FSD benefit portal to submit your renewal packet.
Upload: Submit your renewal form and supporting documents through the FSD upload portal.
By phone: Call 1-855-373-4636, choose your language, and select the MO HealthNet option to complete your renewal over the phone.
By mail: Send your completed packet to the address indicated on the mailing.
In person: Visit your local FSD resource center to submit your packet in person.
The state will reach out to you via phone, email, and/or text alerts if your deadline is approaching and your completed renewal packet hasn’t been submitted. Once your renewal packet is received, the FSD will take around 30 days to process your renewal.
Then, you will receive a decision letter in the mail with 1 of 3 determinations:
No change: This means you are still eligible for MO HealthNet and your coverage will be renewed.
Change in coverage: This means you are still eligible for MO HealthNet, but a different type of coverage is a better fit. You will receive directions on how to proceed, if needed.
Adverse action: This means are no longer eligible for MO HealthNet. If you disagree with this decision, you will have 10 days from the date on the letter to submit an appeal. The letter will also discuss other health insurance options.
If you need to reach Missouri Medicaid by phone, call 1-855-373-4636, choose your language, and select the MO HealthNet option.
What should I do if I lose my Medicaid coverage in Missouri?
In order to receive Medicaid in Missouri, you must meet all of the following criteria:
You must be a Missouri 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 Missouri, 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
A woman between the ages of 18 and 55, don’t have health coverage, and meet certain criteria, (such as having family planning needs)
Blind or have another disability
A household member of someone who has a qualifying disability
Age 65 or older (and meet certain criteria)
A former foster child who is 25 or younger
In need of nursing home care
In need of treatment for breast or cervical cancer (and have been diagnosed or are still undergoing treatment)
If you no longer qualify for Medicaid or the FSD can’t reach you, you will no longer be able to use your benefits — which could leave you temporarily uninsured. You should reapply for Medicaid if you lose coverage and believe you still qualify, however. Just keep in mind that you may be without insurance while you wait to be approved.
If you lost coverage because you didn’t submit your renewal on time, your case can be reconsidered if you submit your form within 90 days of the due date. After that 3-month grace period, you will have to reapply.
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 an ACA health plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid coverage during the redetermination process, you can purchase a plan through the ACA marketplace during the unwinding special enrollment period from March 31, 2023 to July 31, 2024.
Employer plan: If you have a job, you may be able to get 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 that 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.
Missouri Medicaid resources
Here are some resources where you can learn more about Medicaid in Missouri and upcoming changes related to the end of the PHE:
Missouri Medicaid office: The Missouri DSS oversees the state’s Medicaid program, MO HealthNet, which is run by the FSD.
Missouri Medicaid self-service portal: Access the FSD benefits portal to confirm or update your MO HealthNet contact information at any time.
Missouri Medicaid redetermination: Read more about Missouri’s Medicaid unwinding plan.
Missouri Medicaid FAQs: Find the answers to frequently asked questions about eligibility reviews resuming and how to renew coverage.
Missouri Medicaid phone assistance: You can call 1-855-373-4636, choose a language, then select the MO HealthNet option for help with the renewal process.
The bottom line
Automatic Medicaid renewals stopped on March 31, 2023, in advance of the COVID-19 public health emergency (PHE) coming to an end on May 11, 2023.
Missouri started reviewing Medicaid eligibility for enrollees in April 2023 and will continue processing cases over the next year. That’s why it’s important for you to update your contact information with the Missouri Family Support Division (FSD), so that you can be reached when it is your turn to renew.
The FSD will confirm some people’s eligibility automatically. If your case can’t be processed this way, you’ll be sent a yellow renewal packet in the mail. Be sure to submit the renewal form and supporting documentation by the due date listed on the packet.
If you lose your Medicaid coverage, you may still qualify for other health insurance options, such as an Affordable Care Act (ACA) marketplace plan, Medicare, or job-based coverage.
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References
Administration for Strategic Preparedness and Response. (2020). Determination that a public health emergency exists.
Administration for Strategic Preparedness and Response. (2023). Renewal of determination that a public health emergency exists.
Bates, C. (2023). 200,000 Missourians estimated to lose Medicaid as eligibility renewals resume. Missouri Independent.
Centers for Medicare & Medicaid Services. (n.d.). Unwinding and returning to regular operations after COVID-19.
Missouri Department of Social Services. (n.d.). Medicaid annual renewals: Outreach material.
Missouri Department of Social Services. (n.d.). Renewing your MO HealthNet Coverage.
Missouri Department of Social Services. (n.d.). Renew timeline.
Missouri Department of Social Services. (2023). Eligibility requirements for MO HealthNet coverage.
Missouri Department of Social Services. (2023). Missouri's plan for resuming Medicaid renewals.
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.
