Medicaid Unwinding in Rhode Island: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Rhode Island are changing because of the end of the COVID-19 public health emergency (PHE), which concluded on May 11, 2023. The end of the PHE resulted in what 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.
Rhode Island’s Medicaid program has started reviewing eligibility again. If you’re enrolled in the program, make sure the state’s Executive Office of Health and Human Services (EOHHS) has your current contact information. If the agency can’t reach you or if you’re no longer eligible, you could lose coverage as early as June 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 between January 2020 and February 2023.
Congress mandated that all states, including Rhode Island, and territories provide continuous Medicaid and Children’s Health Insurance Program (CHIP) coverage during the COVID PHE. Until recently, people who were enrolled in Medicaid or CHIP — which is called RIte Care in Rhode Island — at any time during the PHE were able to keep their coverage without having their eligibility reviewed.
But the PHE ended on May 11, 2023, which was preceded by automatic renewals for Medicaid stopping nationwide on March 31. These changes could cause 5 million to 14 million enrollees across the country to lose Medicaid coverage.
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Rhode Island has resumed Medicaid eligibility reviews through a process called redetermination. And residents who no longer qualify for coverage could be disenrolled as early as June 2023. The Rhode Island Executive Office of Health and Human Services (EOHHS) estimates that this could affect 25,000 to 30,000 people in the state who are enrolled in Medicaid or RIte Care.
Here’s what you need to know about Medicaid changes in Rhode Island and what to do if you lose coverage.
Why is Medicaid changing nationwide?
The end of the PHE shifts COVID to a public health priority. As part of this process, Medicaid renewals are no longer automatic. This is being referred to as the unwinding of Medicaid.
The unwinding process will affect Medicaid in every state, Washington, D.C., and five U.S. territories.
What’s happening with Medicaid renewal in Rhode Island?
The Rhode Island EOHHS is responsible for overseeing the state’s Medicaid program. The agency’s Medicaid renewals page outlines how the state plans to conduct eligibility reviews for more than 350,000 current enrollees — about one-third of Rhode Island’s 1.1 million residents.
If you’re enrolled in Medicaid in Rhode Island, it’s important for you to confirm or update your household’s contact information with the EOHHS, so you can receive renewal notices and other important alerts about your health coverage. You can confirm or update your mailing address, phone number, email address, and other information — such as income or household size — by:
Logging in to your account on the HealthSource RI consumer portal
Calling HealthSource RI at 1-855-840-4774
Logging on to the HealthyRhode mobile app
Visiting a Rhode Island Department of Human Services (DHS) office
Calling the number on the back of your insurance card if you have Neighborhood Health Plan of Rhode Island, Tufts Health Plan (RITogether), or UnitedHealthcare Community Plan (UHCCP)
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To urge enrollees to update their contact information with the EOHHS, the state has launched an outreach campaign called Stay Covered RI, which provides residents with information about the redetermination process.
What to expect during the renewal process
Every Rhode Island resident who is receiving Medicaid or RIte Care — the state’s Medicaid managed care program for children, pregnant people, and families with children — will go through the eligibility redetermination process.
The state began eligibility reviews on April 1, 2023 and is using a tiered approach to ensure the most vulnerable enrollees have more time to prepare. (For instance, households with children won’t start their renewals until December 2023.) Your estimated renewal date can be found under “My Renewal Information” on your HealthSource RI account dashboard.
The EOHHS estimates that half of Medicaid enrollees in Rhode Island — about 150,000 — will go through a passive renewal process. That means the state has enough eligibility information from other programs to renew an enrollee automatically. If you are in this group, you will receive a notice asking you to review your information and only contact the state if something is not correct.
For the other half of Medicaid enrollees, action will be required to maintain coverage. If you are in this group, you will receive a yellow renewal letter in the mail. You’re required to respond within 30 days of the date listed on the letter.
There are multiple ways to provide the information requested via the renewal letter, including by mail and through the HealthSource RI consumer portal. If you have coverage through a Medicaid managed care organization, like RITogether or UHCCP, you can respond by calling the number on the back of your insurance card.
Before the deadline, you will receive a reminder to submit your renewal packet and documents. Once your renewal packet is submitted, you will be sent a notice that your information was received and your review is pending. You will eventually receive a coverage decision letting you know you’ve been approved or denied.
If you are denied coverage, you will be informed of health insurance alternatives, including Affordable Care Act (ACA) marketplace plans on HealthSource RI.
Tribal health and Medicaid unwinding
The National Indian Health Board estimates that as many as 236,000 American Indians and Alaska Natives could lose coverage during the unwinding process. As a result, Rhode Island state liaisons are reaching out specifically to people who are enrolled in Medicaid and are members of or affiliated with Native American tribes. This includes members of the Narragansett Indian Tribe.
What should I do if I lose my Medicaid coverage in Rhode Island?
In order to qualify for Medicaid in Rhode Island, you must meet all of the following criteria:
You must be a Rhode Island 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 Rhode Island, 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 or younger
Blind
65 or older (and meet certain criteria)
A person with a disability or a household member of someone who has a qualifying disability
A former foster child
In need of nursing home care
Age 19 or older and have 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 for Medicaid or the EOHHS can’t reach you, you will not 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. But you still may be uninsured for a period, while you’re waiting to be reapproved for coverage.
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 might be able to take advantage of one of these other insurance options:
ACA marketplace plan: You may be able to enroll in a plan on HealthSource RI, which is the state’s ACA marketplace. You could even find a plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid, you can transition to an ACA plan through HealthSource RI 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 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) benefits: If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Rhode Island Medicaid resources
Here are some resources where you can learn more about Medicaid in Rhode Island and upcoming changes related to the end of the PHE:
Rhode Island Medicaid office: The Rhode Island EOHHS oversees and administers the state’s Medicaid program.
Rhode Island Medicaid self-service portal: You can access your account on the HealthSource RI consumer portal 24/7 to confirm or update your contact information.
Rhode Island Medicaid redetermination: Read more about Rhode Island’s Medicaid redetermination plan at Stay Covered RI.
Rhode Island Medicaid office phone assistance: You can call HealthSource RI at 1-855-840-4774.
Rhode Island Medicaid FAQs: Read the answers to frequently asked questions about Medicaid unwinding in this state.
The bottom line
Automatic Medicaid renewals stopped nationwide on March 31, 2023, in advance of the COVID-19 public health emergency (PHE) concluding on May 11, 2023.
As a result, the Rhode Island Executive Office of Health and Human Services (EOHHS) started reviewing Medicaid enrollees’ eligibility in April 2023 and will continue this auditing for a year. If you’re enrolled in Medicaid in the state, make sure you update your contact information with the EOHHS, so you can be reached when it’s your turn to renew.
Even if you lose Medicaid coverage, you may still qualify for health insurance through another provider. Your options may include Medicare, an Affordable Care Act (ACA) marketplace plan through HealthSource RI, 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.
Benefits.gov. (n.d.). Rhode Island medical assistance (Medicaid).
Centers for Medicare & Medicaid Services. (2019). Centers for Medicare & Medicaid Services serving American Indians and Alaska Natives in Connecticut, Maine, Massachusetts, and Rhode Island.
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).
Executive Office of Health and Human Services State of Rhode Island. (n.d.). RIte Care.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
Sherman, E. (2023). At least 25K people likely to get kicked off Medicaid in RI beginning in April. WPRI.com.
State of Rhode Island Department of Human Services. (n.d.). DHS offices.
State of Rhode Island Governor Dan McKee. (2023). McKee administration, community partners roll out plan for restarting state Medicaid renewals.
State of Rhode Island Stay Covered RI. (n.d.). Medicaid renewal information for members.
State of Rhode Island Stay Covered RI. (n.d.). Medicaid renewals and the return to normal operations.
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.
