Idaho’s Medicaid emergency protections ending

During the COVID-19 pandemic, Medicaid Protection allowed individuals to remain enrolled in Medicaid coverage who otherwise would have been ineligible, but this protection has recently ended. The Idaho Department of Health and Welfare (IDHW) is reevaluating Medicaid eligibility. Beginning April 2023, individuals who no longer meet Medicaid eligibility rules will be removed from Medicaid. Here are some common questions and answers about this change.

How will I know if my Medicaid coverage is impacted?

As IDHW reviews Medicaid eligibility, individuals will receive one of the following notices:

• Letter to Non-Medicaid Protection customers: Non-Medicaid Protection customers will get a one-time letter on blue paper stating that Medicaid Protection is ending. This is only for an individual’s eligibility and does not impact a household’s eligibility.
• Reevaluation notices: Anyone who has Medicaid coverage will get a reevaluation notice approximately 60 days before their reevaluation submission is due. Individuals can call IDHW at 877-456-1233 or use the idalink portal to complete their reevaluation for Medicaid coverage, or their coverage will end.
• Letter to Medicaid Protection customers: Medicaid Protection customers will get a letter on pink paper that explains Medicaid Protection is ending and what they need to do to get coverage.
• Reevaluation reminder: Medicaid customers will get a second notice, as well as a text message if IDHW has their mobile number, to remind them to complete their reevaluation approximately 30 days before their reevaluation is due. The notice will include contact information for IDHW’s Self Reliance office for anyone who needs help submitting their reevaluation.

What should I do if lose Medicaid coverage?

If IDHW determines you are no longer eligible for Medicaid, you may still be eligible for an advance premium tax credit (APTC). An APTC is a subsidy that can be used toward a premium for an Affordable Care Act (ACA) plan. ACA plans are available through Idaho’s online health insurance marketplace, Your Health Idaho. You can also find out if you are eligible for a tax credit through Your Health Idaho. Tax credits can only be used toward premiums for plans that are purchased through Your Health Idaho.

When will IDHW begin transitioning Medicaid-protected members?

IDHW ended the Medicaid Protection on April 1. All Idaho Medicaid eligibility rules that were in place before the pandemic will be reinstated. IDHW began the reevaluation process for Medicaid eligibility on February 1 for renewals or terminations beginning on April 1. IDHW will reevaluate Medicaid eligibility in phases through fall 2023.

How much time do I have to submit a reevaluation?

Individuals will have 60 days to complete a reevaluation. For example, if an individual is notified on February 1 to provide a reevaluation, they need to submit their reevaluation to IDHW by April 1.

If I am not eligible for Medicaid, how much time do I have to enroll in a new plan?

If IDHW determines you are not eligible for Medicaid, you will have 60 days from the date your Medicaid coverage ends to enroll in a health insurance plan offered through Your Health Idaho through a Special Enrollment Period. To avoid a gap in coverage, you can enroll in a health plan before your Medicaid coverage ends.  

How can I purchase a new plan?

You can find a new plan in a few ways:

• By visiting Your Health Idaho’s website, where you can check to see if you are eligible for a tax credit and extra savings.
• By working with a broker. Brokers are state-licensed, certified independent insurance representatives who can offer you free and unbiased support to help you find the best health plan for your needs.  

Can I use a tax credit toward a premium for a Blue Cross of Idaho plan?

Blue Cross of Idaho ACA plans are available on Your Health Idaho, and are eligible for premium tax credits. You will need to apply for a Blue Cross of Idaho ACA plan through Your Health Idaho to use a tax credit toward your plan’s premium.

If you qualify for a tax credit towards your premium, you may also qualify for extra savings (also called cost-sharing reductions). Cost-sharing reductions lower your out-of-pocket maximum, which can lower the amount you pay for healthcare services each year. You must enroll in a Silver plan to take advantage of these cost-sharing reductions.

Even if you do not qualify for a tax credit, you still have options during your Special Enrollment Period to purchase an ACA plan or Access plan from Blue Cross of Idaho.

What Blue Cross of Idaho plans are available on Your Health Idaho?

Blue Cross of Idaho’s ACA plans through Your Health Idaho offer a variety of coverage levels to meet your personal and financial needs. There are three categories of ACA plans:

• Gold plans, which offer lower deductibles but higher premiums
• Silver plans, which can lower your out-of-pocket expenses
• Bronze plans, which have higher deductibles but lower premiums

Where can I find more information about Idaho Medicaid protection changes?

Visit IDHW’s website for more information on these changes.

 

Blue Cross of Idaho is providing this information for general informational purposes only. Do not act or refrain from acting based on this information without first seeking advice from the advisor of your choice to ensure this information and your interpretation of it is applicable or appropriate to your circumstances.

Blue Cross of Idaho is a tradename for Blue Cross of Idaho Health Service, Inc. All descriptions of coverage are subject to the provisions of our Member Contract/Enrollee Certificate. Please refer to your Member Contract/Enrollee Certificate for a complete description of benefits, exclusions and conditions of coverage. These plans are only offered/available to Idaho residents.

 

Posted: May 17, 2023