Medicaid Unwinding in South Carolina: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in South Carolina 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 South Carolina Department of Health and Human Services (DHHS) has started Medicaid eligibility reviews. Make sure the DHHS has your current contact information. If they can’t reach you, or if you’re no longer eligible for Medicaid or Partners for Healthy Children (PHC) — the state’s CHIP program — 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. From January 2020 to February 2023, the PHE was renewed a dozen times.
People who were eligible for Medicaid coverage during the PHE got to keep their health insurance — even if they no longer met eligibility requirements. This is because all states, including South Carolina, were required to provide continuous coverage during the PHE.
But the PHE ended on May 11, 2023, and most COVID provisions, like automatic Medicaid renewals, stopped nationwide in March. This process is being called the unwinding of Medicaid. Over the next year, 5 million to 14 million enrollees nationwide could lose Medicaid coverage.
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Here’s what you need to know about Medicaid changes in South Carolina, and what to do if you lose your insurance coverage during the Medicaid unwinding.
Why is Medicaid changing nationwide?
Now that the PHE has ended, COVID-19 remains a public health priority — just not an emergency. As a result, Medicaid renewals will no longer be automatic.
The process of determining eligibility and enrolling in Medicaid will return to the way it was before the pandemic. This is being referred to as the unwinding of Medicaid.
The unwinding could affect millions of people in all states, Washington, D.C. and five U.S. territories.
What’s happening with Medicaid renewal in South Carolina?
The South Carolina Department of Health and Human Services (DHHS) has resumed eligibility reviews for about 1.3 million people enrolled in Medicaid and Partners for Healthy Children (PHC), the state’s version of CHIP. This is called the redetermination process.
People who no longer qualify could be disenrolled as early as June 2023. In fact, the DHHS estimates that 200,000 to 300,000 people in the state could lose Medicaid coverage.
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It’s important for you to confirm or update your household’s contact information with the DHHS. You can do this by:
Logging into your account on the Healthy Connections self-service portal
Calling the South Carolina Medicaid helpline at 888-549-0820
Visiting a local county Healthy Connections office
What to expect during the renewal process
DHHS will review eligibility for current Medicaid members for the next year. Some people may not receive renewal forms until March 2024.
First, the DHHS will attempt to renew enrollees who have current information on file. You'll receive a continuation of benefits letter if your Medicaid can be automatically renewed. Otherwise, you will receive a renewal form with a submission deadline within 60 days. Here’s an example of the renewal form you may receive.
You can submit your completed renewal form by:
Completing a digital version on the Healthy Connections self-service portal
Scanning your documents and uploading them using the document upload tool.
Mailing it to DHHS at: SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101
Faxing it to 888-820-1204
Emailing it to 8888201204@fax.scdhhs.gov
Delivering it to a local county Healthy Connections office
If the DHHS has your phone number on file, you may receive text messages reminding you to complete your renewal form.
If you need to reach South Carolina Medicaid, you can call 888-549-0820.
Tribal health and Medicaid unwinding
South Carolina liaisons are reaching out to people who are enrolled in Medicaid and who are also affiliated with or members of Native American tribes.
The National Indian Health Board estimates that as many as 236,000 American Indians and Alaska Natives could lose coverage during the unwinding process. State advocates are working to ensure eligible people in these groups keep their Medicaid coverage.
What should I do if I lose my Medicaid coverage in South Carolina?
In order to receive Medicaid in South Carolina, you must meet all of the following criteria:
You must be a South Carolina 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 South Carolina, you may also qualify for reasons other than and in addition to income, including if you:
Are pregnant
Are a child age 18 or younger
Are responsible for the care of a dependent child
Are blind or have another disability
Are age 65 or older (and meet certain criteria)
Have a person in your household who has a qualifying disability
Are a former foster child under age 26
Are in need of nursing home care
Have family planning needs
Need of treatment for breast or cervical cancer
If you no longer qualify or DHHS 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.
Alternatives to Medicaid in South Carolina
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 find other health insurance coverage and care, such as:
Affordable Care Act (ACA) marketplace plan: On the ACA health insurance marketplace, you may be able to find an affordable health plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid, you can purchase a plan 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, which include fixed indemnity, accident, cost-sharing, and catastrophic insurance.
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.
South Carolina Medicaid resources
Here are some resources to help you learn more about Medicaid in South Carolina and upcoming changes related to the end of the PHE:
South Carolina Medicaid office: The South Carolina Department of Health and Human Services (DHHS) oversees and administers the state’s Medicaid program.
South Carolina Medicaid self-service portal: You can visit the Healthy Connections self-service portal and access your account online 24/7 to confirm or update your contact information.
South Carolina Medicaid phone assistance: You can call Healthy Connections at 888-549-0820.
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.
The South Carolina Department of Health and Human Services (DHHS) will be reviewing Medicaid renewals over the next year. This process is known as Medicaid redetermination.
It’s important for DHHS to have your up-to-date contact information. If the DHHS can’t reach you or you no longer qualify for Medicaid, you could lose coverage as early as June 2023.
If you are no longer eligible for Medicaid, you might be able to obtain health insurance another way. Consider options like an Affordable Care Act plan, employer-sponsored insurance, or Medicare.
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References
Administration for Strategic Preparedness & Response. (2023). Renewal of determination that a public health emergency exists.
Administration for Strategic Preparedness & Response. (2020). Determination that a public health emergency exists.
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).
Corwin, T. (2023). SC will begin review of whether families and children still qualify for Medicaid coverage. The Post and Courier.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
South Carolina Department of Health and Human Services. (n.d.). Frequently asked questions.
South Carolina Department of Health and Human Services. (n.d.). Medicaid.
South Carolina Department of Health and Human Services. (n.d.). Members.
South Carolina Department of Health and Human Services. (n.d.). Partners for Healthy Children (PHC).
South Carolina Department of Health and Human Services. (2023). Medicaid eligibility annual reviews resuming next week, new document upload tool available for Healthy Connections Medicaid members.
South Carolina Public Radio. (2023). What to know about the end of suspended Medicaid reenrollments in South Carolina.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
Tribal Health Reform Research Center. (n.d.). Medicaid Unwinding.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
