Medicaid Unwinding in Utah: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Utah are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This is being referred to as the unwinding of Medicaid, and some people will lose coverage during this process.
During the PHE, Medicaid and Children’s Health Insurance Program (CHIP) renewals were automatic, and enrollees had continuous coverage until March 31, 2023. Now that automatic renewals have ended, Utah Medicaid eligibility reviews have resumed, and you could lose coverage as soon as May 1, 2023.
If you lose your Medicaid coverage in Utah, you’ll be notified of alternative low-cost insurance options for you and your children — including the Affordable Care Act marketplace.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020, which was renewed a dozen times through February 2023.
If you were enrolled in Medicaid at any point during the PHE, you kept your health insurance without eligibility reviews. That’s because Utah, like all states, was required to provide continuous coverage during the pandemic.
Automatic Medicaid renewals stopped in March 2023 ahead of the PHE ending on May 11, 2023. This is being called the unwinding of Medicaid, and up to 200,000 people in Utah could lose Medicaid or Children’s Health Insurance Program (CHIP) coverage because of it.
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States, including Utah, are resuming reviews of Medicaid and CHIP enrollees to determine who is eligible to continue enrollment. This process is called redetermination. If you or your family members no longer qualify for Medicaid or CHIP, you could potentially lose coverage as early as May 1, 2023.
Here’s how to prepare for Medicaid changes in Utah and what to do if you lose your coverage.
Why is Medicaid changing nationwide?
After the PHE ends, COVID-19 will remain a public health priority — but not an emergency. As part of this process, Medicaid renewals will no longer be automatic, and millions of people nationwide risk losing Medicaid coverage.
The unwinding will affect Medicaid in every state, the District of Columbia, and five U.S. territories.
What’s happening with Medicaid renewal in Utah?
Utah’s Department of Workforce Services (DWS) is the office responsible for overseeing Utah Medicaid. Utah has a redetermination plan that explains how the state intends to handle the Medicaid unwinding.
DWS officials have resumed Utah Medicaid eligibility reviews and plan to continue through March 2024. Utah Medicaid members will be assigned a renewal month, and your case will stay open until DWS completes a review.
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Each person in your household currently receiving Medicaid or CHIP will be notified about their eligibility. You’ll want to pay close attention to your mail or email for notices. You can also check your account in Utah Medicaid’s myCase online portal to see your review date.
The state has enough information to automatically review some Medicaid enrollees. Those members will receive a notice that their review is complete. If DWS doesn’t have enough information, you will be asked to complete a form and may need to provide supporting documentation.
Make sure DWS has your current contact information so that they will be able to reach you when it’s time for your review. You can confirm or update your contact information by:
Visiting Utah Medicaid’s myCase online portal.
Updating your information with your health plan.
Calling DWS toll free at 866-435-7414 or the Utah CHIP and Medicaid office toll free at 866-608-9422. Keep in mind that you may experience longer-than-usual wait times to speak to an eligibility worker.
Tribal health
Utah Medicaid liaisons are working to reach 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 could lose coverage during the unwinding. Advocates are working to ensure eligible individuals in these groups keep their health insurance.
What should I do if I lose my Medicaid coverage in Utah?
Through March 2024, the DWS will review eligibility for everyone receiving Medicaid. You can receive Medicaid in Utah if you meet all of the following criteria:
You are a Utah resident.
You are a U.S. citizen, permanent resident, or legal resident.
You need healthcare or insurance assistance.
Your annual household income before taxes are withheld meets the limit for your household size.
And you are one of the following:
Pregnant
In charge of caring for a child 18 years old or younger
Blind
65 years old or older (under certain conditions)
Person with a disability, or have a family member in your household who has a disability
If you no longer meet the eligibility guidelines, your Medicaid won’t be renewed and you will no longer have coverage. If you are no longer eligible for Medicaid, DWS will send:
Advance notice of when your enrollment ends
Information on how to appeal the decision
Options for buying other types of health insurance
A direct transfer of your application to the Affordable Care Act marketplace (unless you were disenrolled for failing to complete or return paperwork)
If you lose coverage, you can consider free and low-cost healthcare options. You can also use free GoodRx coupons to save on your prescription medications.
You should see if you qualify for coverage elsewhere if you don’t plan to reapply for Medicaid and aren’t eligible for another government healthcare program. Depending on your circumstances, you may be able to find health insurance with one of these options:
Affordable Care Act (ACA) marketplace: Through the ACA exchange, you may be able to find coverage for $10 or less per month if you qualify for a premium subsidy. If you lose your Medicaid coverage, you’ll be able to purchase an ACA plan during an unwinding special enrollment period from March 31, 2023 to July 31, 2024. If you need help with your application, Take Care Utah navigators can help you.
Employer plan: You may now have a job that offers health insurance.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis, or 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.
Utah Medicaid resources
Here are some sites where you can learn more about Medicaid in Utah and upcoming changes related to the end of the public health emergency:
Utah Medicaid office: The Utah Department of Health and Human Services oversees Utah Medicaid.
Utah Medicaid self-service portal: You can log in to your Medicaid account 24/7 through the My Case portal to update or confirm your contact information.
Utah Medicaid redetermination: This site provides information about the Utah Medicaid redetermination plan.
Utah Medicaid unwinding FAQs: The state has prepared answers to frequently asked questions about the end of continuous Medicaid coverage.
The bottom line
Automatic Medicaid renewals stopped at the end of March 2023 in advance of the end of the COVID-19 public health emergency on May 11, 2023.
Utah has resumed reviewing Medicaid eligibility for enrollees and will continue through April 2024. During that time, you’ll be renewed without any action needed or you will be contacted by state officials to complete the renewal process. You may be asked to provide supporting documentation.
It’s important for you to confirm and update your contact information online or by calling DWS so you can be reached when it’s your turn for a review.
If you lose your Medicaid coverage, you may still 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. (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). Unwinding and returning to regular operations after COVID-19.
Department of Health & Human Services 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).
Kim, B. (2023). Utah DHHS focused on preparedness for Medicaid redeterminations in April. State of Reform.
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 Veteran Affairs. (2022). VA & TRICARE information.
Utah Department of Health & Human Services. (n.d.). Unwinding continuous Medicaid eligibility.
Utah Department of Health & Human Services. (n.d.). Who is eligible?
