Medicaid Unwinding in Montana: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Montana 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.
The Montana Department of Public Health and Human Services (DPHHS) has started reviews to see who is eligible to continue receiving Medicaid coverage. Make sure the DPHHS has your current contact information. If they can’t reach you, or if you’re no longer eligible for Medicaid, you could lose coverage as early as June 1, 2023.
If you lose Medicaid coverage during the unwinding, you may qualify for a low-cost, alternative health insurance option, such as an Affordable Care Act 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 between January 2020 and February 2023.
People who were eligible for Medicaid coverage at the start of the PHE were able to keep their insurance during the pandemic — even if they were no longer eligible. This is because all 50 states — including Montana — were required to provide continuous coverage during the PHE.
The PHE ends in May 2023, and automatic renewals for Medicaid stopped in March 2023.
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Here’s what you need to know about Medicaid changes in Montana 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. This process is already underway and could cause 5 million to 14 million Medicaid enrollees nationwide to lose coverage.
The unwinding will affect Medicaid in every state, Washington, D.C., and five U.S. territories.
What’s happening with Medicaid renewal in Montana?
The Montana Department of Public Health and Human Services (DPHHS) is responsible for overseeing the state’s Medicaid program and its Children’s Health Insurance Program (CHIP), which is called Healthy Montana Kids. In February 2023, nearly 323,000 Montana residents were enrolled in Medicaid.
DPHHS resumed eligibility determinations for Medicaid and CHIP enrollees in April 2023 and plans to continue reviewing cases for 10 months. This is called the redetermination process. Anyone who no longer qualifies could be disenrolled as early as June 1, 2023. The final group will be processed in January 2024. The state is tracking its progress on reviewing cases via a Medicaid enrollment dashboard.
The George Washington University released a report, which had input from Montana health officials, estimating that about 71,000 people in the state could lose Medicaid or CHIP coverage by January 2024. A Kaiser Family Foundation predicted up to 86,700 people in Montana could lose Medicaid or CHIP coverage during this process.
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How to renew your coverage
It’s important for Montana Medicaid to be able to reach you about renewing your coverage. That’s why you need to confirm or update your household’s contact information — as well as report any changes in your household, such as income — to DPHHS.
You can confirm or update your information by:
Logging in to your account on the Montana DPHHS self-service portal
Using the online Medicaid change of address form
Calling the Montana DPHHS Public Assistance Helpline at 1-888-706-1535 and pressing 1 to update your address
Visiting a local Office of Public Assistance or local Tribal Medicaid Office
Mailing a letter to DPHHS, P.O. Box 202925, Helena, MT 59620-2925
Faxing a letter to 1-877-418-4533
In Montana, the redetermination process for an individual or household begins with the state attempting to renew your case automatically in the month before your redetermination date. If that’s successful, you will receive a notice confirming your ongoing eligibility.
If the automatic renewal isn’t successful, you will receive a renewal packet due by the 10th of the next month, which is your renewal month. You will receive a reminder a few days before the end of the renewal month. You should have at least 30 days to complete the renewal packet.
There are three ways to complete the renewal packet:
Online through the Montana DPHHS self-service portal
By calling 1-888-706-1535
By returning the completed forms by mail
If your renewal packet information is received by the deadline, your case will be reviewed and you will receive a notice of the decision. If your renewal packet is not received on time, your coverage will end on the last day of your renewal month. You’ll receive a notice about disenrollment at least 10 days before your coverage ends. You could lose coverage as soon as June 1, 2023. If that happens, you may need to reapply if you still qualify.
Just to review, here’s what you should receive in the mail:
If the state already has your correct address, you should have received a Medicaid redetermination notice urging you to update or confirm your contact information.
If the state can’t confirm your eligibility, you should then receive a renewal packet in the mail.
You should also receive a reminder letter about the deadline to return your renewal packet.
Tribal health
DPHHSMedicaid outreach includes contacting about 55,000 people who are enrolled in Medicaid and who are also members of or affiliated with American Indian tribes. The National Indian Health Board estimates that as many as 236,000 American Indians and Alaska Natives (AIs/ANs) could lose coverage during the unwinding — including 4,747 to 5,050 AI/AN people in Montana.
What should I do if I lose my Medicaid coverage in Montana?
In order to receive Medicaid in Montana, you must meet all of the following criteria:
You must be a Montana 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 Montana, you may also qualify for reasons in addition to income, including if you are:
Pregnant
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
If you no longer qualify or DPHHS 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: 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, you can purchase a plan in the ACA marketplace during the unwinding special enrollment period from March 31, 2023 to July 31, 2024. If you need help, you can get free assistance from Cover Montana.
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, to 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): If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Montana Medicaid resources
Here are some resources where you can learn more about Medicaid in Montana and upcoming changes related to the end of the public health emergency:
Montana Medicaid office: The Montana Department of Public Health and Human Services (DPHHS) oversees and administers the state’s Medicaid program.
Montana Medicaid self-service portal: You can visit the DPHHS self-service portal to confirm or update your contact information. You can also complete your renewal packet through this website.
Montana Medicaid redetermination: Read more about Montana’s Medicaid updates, find out how to stay covered, and get answers to frequently asked questions.
Montana Medicaid assistance by phone: You can call the DPHHS Office of Public Assistance at 1-888-706-1535.
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.
Montana will be reviewing Medicaid eligibility for enrollees through January 2024. During that time, your case could be renewed automatically. If not, you will be contacted by mail about an eligibility review. It’s important for the Montana Department of Public Health and Human Services to have your current contact information so you can be reached when it’s your turn for review.
If you lose your Medicaid coverage, you may qualify for health insurance elsewhere. Your options may include ACA marketplace plans, Medicare, or job-based insurance.
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References
Administration for Strategic Preparedness & Response. (2020). Determination that a public health emergency exists.
Administration for Strategic Preparedness & Response. (2023). Renewal of determination that a public health emergency exists.
Amestoy, A., et al. (2023). What you need to know about Medicaid eligibility and redetermination. Montana Public Radio.
Benefits.gov. (n.d.). Montana Medicaid.
Burns, A., et al. (2023). How many people might lose Medicaid when states unwind continuous enrollment? Kaiser Family Foundation.
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).
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
Montana Department of Public Health & Human Services. (2023). Medicaid eligibility redeterminations and renewals to resume in April.
Montana Department of Public Health & Human Services. (2023). Medicaid updates.
Ortiz, R. (2023). Indian Health Service Medicaid unwinding. National Indian Health Board.
Platt, I., et al. (2023). The end of the continuous enrollment period in Montana. The George Washington University.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
Tribal Health Reform Resource Center. (n.d.). Medicaid unwinding.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
