Medicaid Unwinding in Washington State: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid in Washington state is changing because the COVID-19 public health emergency (PHE) ended on May 11, 2023. As a result, some people will lose coverage through a process being called the unwinding of Medicaid.
Medicaid renewals were automatic during the PHE, 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.
Apple Health — Washington state’s Medicaid program — has started reviewing enrollees’ eligibility. If you’re enrolled in Apple Health, make sure the Washington State Health Care Authority (HCA) has your current contact information. If you can’t be reached or no longer qualify, you could lose coverage as early as May 31, 2023.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. From then through February 2023, the PHE was renewed a dozen times.
People who were enrolled in Medicaid at any point during the COVID PHE got to keep their coverage without having their eligibility reviewed. This is because states — including Washington — and territories were required to provide continuous coverage during the PHE.
But the PHE officially ended on May 11, 2023, after automatic Medicaid renewals stopped nationwide on March 31. Over the next year, 5 million to 14 million enrollees across the country could lose Medicaid coverage.
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Like many other states, Washington has resumed eligibility reviews for Medicaid enrollees through a process called redetermination. Residents who no longer qualify for coverage could be disenrolled as early as May 31, 2023. And officials estimate that about 300,000 people in the state could lose Medicaid coverage over the next year.
Here’s what you need to know about Medicaid changes in Washington State, and what to do if you lose coverage.
Why is Medicaid changing nationwide?
Now that the PHE has ended, COVID remains a public health priority — just not an emergency. As a result, Medicaid renewals are no longer automatic.
The process of determining eligibility for Medicaid is returning to the way it was before the pandemic. These procedure changes are collectively being referred to as the unwinding of Medicaid.
The unwinding process could affect millions of people across all states, Washington, D.C., and five U.S. territories.
What’s happening with Medicaid renewal in Washington State?
As of April 2023, the Washington State Health Care Authority (HCA), which oversees the state’s Medicaid program, resumed eligibility reviews for enrollees. This so-called redetermination process will last through May 2024 and will involve more than 1.6 million households in Washington state. And HCA officials estimate that about 300,000 people are at risk of being disenrolled from the state’s Medicaid program, which is called Apple Health.
If you’re enrolled in Apple Health, make sure the HCA has your correct information — such as your current mailing address and income status — so that you don’t miss notices about your renewal form. (You can read more about renewal forms and how the state plans to handle eligibility reviews in the HCA’s redetermination plan.) Depending on what type of Medicaid you have, the options for updating and confirming your information are different.
Below, we’ve listed ways to confirm or correct changes for yourself if you are ages 19 to 64 and don’t have Medicare or if you’re pregnant. You can also use these options for a child or other Medicaid enrollee under your care:
Online: Log in to your Apple Health account through the Washington Healthplanfinder self-service portal and select “Report a change in income or household” in the quick links section.
Via the app: Log in to your account on the Washington Healthplanfinder app and select “Report a change in income or household” in the quick links section.
By phone: Call the Washington Healthplanfinder customer support center at 1-855-923-4633.
By email: Send an email to askmagi@hca.wa.gov.
By mail: Send a letter or other document indicating changes to HCA-MEDS, P.O. Box 45531, Olympia, WA 98504.
Apple Health Classic Medicaid enrollees — which include people who are 65 or older, blind or living with another disability, or receiving long-term services and support — can report changes to personal information in these ways:
Online: Log in to your Apple Health account through the Washington Connection self-service portal, select “Report a change,” and follow the prompts.
By phone: Call the Washington State Department of Social and Health Services (DSHS) customer service center at 1-877-501-2233.
By mail: Send a letter or other document indicating changes to DSHS-CSD, PO Box 11699, Tacoma, WA 98411-6699.
What to expect during the renewal process
During Washington state’s yearlong eligibility review process, a renewal form will be mailed to you at least 45 days before your coverage is scheduled to expire. If the state already has enough eligibility information from other programs to renew your coverage, it will be done automatically. If more information is needed, you will receive a renewal packet.
A higher number of renewal packets will be mailed in May through July 2023 compared to subsequent months.
If you’ve been sent a renewal packet and the state does not receive your completed forms, you will be contacted by robocall and text message about 2 weeks before your deadline. If you miss the deadline to submit your renewal packet, you should receive a termination notice at least 10 days before your coverage ends.
If you lose coverage because you miss the renewal deadline, you will have 90 days from the date your Medicaid ends to submit your renewal. If approved, your Medicaid will be retroactively reinstated with no gap in coverage.
If you need to reach Apple Health by phone, call 1-800-562-3022.
Tribal health and Medicaid unwinding
According to the National Indian Health Board, as many as 236,000 American Indians and Alaska Natives (AIs/ANs) could lose coverage during the unwinding process. This may include some of the more than 17,000 AIs/ANs enrolled in Apple Health.
What should I do if I lose my Medicaid coverage in Washington State?
In order to receive Apple Health, you must meet all of the following criteria:
Be a Washington state resident
Be a U.S. citizen, permanent resident, or legal resident
Require assistance with access to healthcare or insurance coverage
Have an annual household income that’s below the limit for your household size before taxes are withheld
In Washington, you may also qualify for reasons other than or in addition to income, such as if you:
Are a child
Are a parent or caretaker of a qualifying individual
Are pregnant
Are blind or have another disability
Have a household member who has a qualifying disability
Are 65 or older (and meet certain criteria)
Are a former foster child
Are in need of long-term care
Are a noncitizen who is eligible for certain emergency care and has a qualifying medical condition
If you no longer qualify for Apple Health or the HCA can’t reach you, you will no longer have access to your Medicaid benefits, which could leave you temporarily uninsured.
Keep in mind that, if you lose your coverage but believe you still qualify, you can reapply for Apple Health.
Alternatives to Apple Health in Washington State
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 plan: Washington state’s ACA health insurance marketplace is called Washington Healthplanfinder. Through the marketplace, you may be able to find a health plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid, you can purchase a plan through the marketplace during an 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.
Washington State Medicaid resources
Here are some resources where you can learn more about the upcoming changes to Medicaid in Washington state:
Washington state Medicaid office: The Washington state HCA oversees and administers the state’s Medicaid program, which is called Apple Health.
Washington state Medicaid self-service portal: Visit the Washington Healthplanfinder self-service portal or use the app to access your account online 24/7 and confirm or update your contact information or income.
Washington state Medicaid redetermination: Read more about Washington state’s redetermination plan.
Washington state Medicaid FAQs: Read the answers to frequently asked questions.
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 Washington State Health Care Authority (HCA) restarted Medicaid eligibility reviews in April 2023 and expects to continue through May 2024. Enrollees who are determined ineligible could lose coverage as soon as May 31, 2023. And, by the end of this process, an estimated 300,000 people in the state are expected to lose coverage.
If you are enrolled in Washington state’s Medicaid program, Apple Health, make sure the HCA has your current information to ensure you receive your renewal notice. If you do lose Apple Health coverage, you may still be eligible for other options, such as Affordable Care Act (ACA) marketplace plans on Washington Healthplanfinder, job-based insurance, or Medicare.
Why trust our experts?
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.
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).
Centers for Medicare & Medicaid Services. (n.d.). Medicaid data dashboard.
Centers for Medicare & Medicaid Services. (n.d.). State report on plans for prioritizing and distributing renewals following the end of the Medicaid continuous enrollment provisions.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
Takahama, E. (2023). Thousands in WA could soon lose Apple Health coverage; here’s how to keep it. The Seattle Times.
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.
Washington Healthplanfinder. (n.d.). Washington Apple Health (Medicaid).
Washington State Health Care Authority. (n.d.). Apple Health and the public health emergency.
Washington State Health Care Authority. (n.d.). Eligibility overview.
Washington State Health Care Authority. (n.d.). Noncitizens.
Washington State Health Care Authority. (n.d.). Update my income or address (report a change).
Washington State Health Care Authority. (2023). Changes to Apple Health continued coverage.
Washington State Health Care Authority. (2023). Continuous enrollment unwind data.
Washington State Health Care Authority. (2023). Unwinding the public health emergency for Apple Health (Medicaid).
Washington State Health Care Health. (2023). Washington Apple Health guide to unwinding from the PHE.
