Medicaid Unwinding in North Dakota: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in North Dakota are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This will lead to a loss of coverage through a process called unwinding.
During the COVID 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 North Dakota Department of Health and Human Services (HHS) has started reviewing who is currently eligible for Medicaid. So make sure the agency has your current contact information if you’re enrolled in the state. If you can’t be reached or are no longer eligible for Medicaid, you could lose coverage as early as June 1, 2023.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. And 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 COVID PHE were able to keep their insurance during the pandemic without having their eligibility reviewed. This is because all states — including North Dakota — and territories were mandated to provide continuous coverage during this period.
But the PHE expires on May 11, 2023, and this marks the end of most COVID provisions — like automatic Medicaid renewals, which stopped nationwide in March. These changes could cause 5 million to 14 million Medicaid enrollees nationwide to lose coverage.
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North Dakota has resumed eligibility reviews for Medicaid and Children’s Health Insurance Program (CHIP) enrollees through a process called redetermination. Residents who no longer qualify for coverage could be disenrolled as early as June 1, 2023.
Here’s what you need to know about Medicaid changes in North Dakota and what to do if you lose your insurance coverage.
Why is Medicaid changing nationwide?
After the PHE ends, 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, the District of Columbia, and five U.S. territories.
What’s happening with Medicaid renewal in North Dakota?
The North Dakota Department of Health and Human Services (HHS) is responsible for overseeing the state’s Medicaid program. The HHS has a redetermination plan that involves reviewing more than 130,000 Medicaid cases from April 2023 through March 2024.
The Kaiser Family Foundation estimates that as many as 35,600 people in North Dakota could lose Medicaid or CHIP coverage during this process.
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If you or your family members are enrolled in Medicaid or CHIP in North Dakota, it’s important for the HHS to be able to reach your household when it’s your turn for an eligibility review. This is particularly urgent if you have moved or have changed your contact information since your last renewal. You can confirm or update your contact information by:
Logging in to your account on the North Dakota Medicaid’s online self-service portal
Calling the North Dakota Medicaid helpline at 1-866-614-6005
Visiting a Human Service Zone office
Emailing applyforhelp@nd.gov
Sending a letter to P.O. Box 5562, Bismarck, ND 58506
If your coverage can’t be automatically renewed because the state needs more information, the HHS may mail you a renewal form. Complete the renewal form and return it to the HHS’ customer support center as soon as possible. Your completion of the form will help the agency determine if you’re still eligible for Medicaid coverage.
You may hear more about renewals resuming through North Dakota Medicaid’s communications campaign, which will include updates via:
Social media
Other digital media
Fact sheets
Radio ads
TV ads
Tribal outreach
Tribal health
North Dakota Medicaid’s outreach plan includes getting information to enrollees who are 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 process. That includes more than 2,000 AI/AN people in North Dakota.
What should I do if I lose my Medicaid coverage in North Dakota?
In order to receive Medicaid in North Dakota, you must meet all of the following criteria:
You must be a North Dakota 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 North Dakota, 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 or have another disability
65 years old or older (and meet certain criteria)
Responsible for the care of a person who has a qualifying disability
A former foster child who is 25 years old or younger
An individual with breast or cervical cancer
If you no longer qualify for Medicaid or the HHS can’t reach you, you may lose your benefits. If you lose your coverage but believe you still qualify, you can reapply for Medicaid. But you may be uninsured for a while while you’re waiting to be reapproved.
If you choose not to reapply for Medicaid coverage, you may be able to take advantage of 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 on the ACA marketplace during the unwinding special enrollment period from March 31, 2023 to July 31, 2024. If you need help choosing a plan, you can receive free assistance from North Dakota Navigators.
Employer plan: If you have a job, 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.
North Dakota Medicaid resources
Here are some resources where you can learn more about Medicaid in North Dakota and upcoming changes related to the end of the PHE:
North Dakota Medicaid office: The North Dakota HHS oversees and administers the state’s Medicaid program.
North Dakota Medicaid self-service portal: You can visit the HHS self-service portal and access your account online 24/7 to confirm or update your contact information.
North Dakota Medicaid redetermination plan: Read more about North Dakota Medicaid renewals and how to stay covered, and find answers to frequently asked questions, in the state’s redetermination plan.
The bottom line
Automatic Medicaid renewals stopped nationwide on March 31, 2023 in advance of the COVID-19 public health emergency (PHE) ending on May 11, 2023. This change is part of a process that’s being called the unwinding of Medicaid.
As part of this process, North Dakota will be reviewing Medicaid eligibility for enrollees through March 2024. During that time, Medicaid enrollees will have their coverage renewed automatically or will be contacted by mail for further information. So, if you’re enrolled in Medicaid, it’s important for the North Dakota Department of Health and Human Services (HHS) to have your current contact information so you can be reached when it’s your turn for a review.
If you lose your Medicaid coverage, you may qualify for health insurance elsewhere. Your options could include Affordable Care Act (ACA) marketplace plans, Medicare, or job-based insurance.
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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.
Burns, A., et al. (2023). How many people might lose Medicaid when states unwind continuous enrollment? Kaiser Family Foundation.
National Indian Health Board. (2023). Medicaid unwinding webinar: Unwinding updates and best practices for tribal enrollment assisters.
North Dakota Health & Human Services. (n.d.). Eligibility.
North Dakota Health & Human Services. (n.d.). Medicaid renewals - Stay covered ND.
North Dakota Health & Human Services. (n.d.). North Dakota Medicaid.
North Dakota Health & Human Services. (n.d.). The end of Medicaid continuous enrollment – What this means for North Dakota.
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.
Tribal Health Reform Resource Center. (2023). Medicaid unwinding.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
