Loss of Medicaid
In January 2020, the federal government declared a Public Health Emergency (PHE) for the coronavirus pandemic. In addition to the PHE, Congress passed the Families First Coronavirus Response Act that kept Medicaid enrollees from being disenrolled from coverage while the PHE was in force. In December 2022, Congress passed an omnibus spending bill called the Consolidated Appropriations Act, 2023 which gave states the green light to begin phasing out Medicaid protections.
As of April 2023, the Idaho Department of Health and Welfare (DHW) has returned to normal eligibility processes. All Medicaid recipients who failed to complete an annual re-evaluation during the PHE must now do so to see if they still qualify for coverage.
- DHW began the re-evaluation of Idahoans covered by Protected Medicaid on February 1, 2023, and is expected to continue through August 31, 2023
- Idahoans found to be ineligible for Medicaid coverage may be eligible for a tax credit that would cover some or all of their monthly health insurance premiums when enrolling in a health plan through Your Health Idaho
- Eligible Idahoans will be granted a Special Enrollment Period (SEP) if they lose their Medicaid coverage. An SEP allows 60 days from the end date of Medicaid coverage to enroll in affordable health insurance through Your Health Idaho
Do you think you may be eligible for affordable health insurance coverage through this Special Enrollment Period? Here are the two situations through which you could qualify:
- You have been covered by Protected Medicaid during all or part of the pandemic, but you no longer qualify.
We are encouraging consumers who are referred to Your Health Idaho to enroll in a plan before their Medicaid coverage end date to avoid a gap in their health insurance coverage. If a consumer does not enroll prior to their end date, they will have 60 days from the date their Medicaid coverage ends to enroll in a health insurance plan through a Special Enrollment Period (SEP) with Your Health Idaho.
- You recently applied for Medicaid coverage and were found to be ineligible.
If you do not qualify for Medicaid coverage but have a Qualifying Life Event (QLE), like getting married or loss of other coverage, you may be eligible to enroll in health insurance and receive a tax credit through Your Health Idaho. A 60-day Special Enrollment Period (SEP) begins on the date of your QLE..
Click one of the links below for step-by-step instructions:
If you don’t qualify for a tax credit, you can still compare the pricing and benefits of all our health plans side-by-side and purchase the coverage that best fits your budget and lifestyle.
Learn more about the benefits of enrolling in a Your Health Idaho health insurance plan by visiting our About YHI page. If you have questions, contact our Customer Support Center by vising our Contact Us page.
Need help finishing your application or choosing the right plan? Your Health Idaho has more than 900 certified agents and brokers across the state available at no cost to you, ready to walk you through the application, help you pick a plan, and answer your questions. Click here to find an agent or broker near you.
In 2020, during the Coronavirus pandemic, Congress passed the Families First Coronavirus Response Act (FFCRA). This act prohibited states from disenrolling consumers from Medicaid during the Federal Public Health Emergency (PHE). This is called the Medicaid Continuous Coverage requirement and led to consumers being on Protected Medicaid.
In December 2022, Congress passed an omnibus spending bill which decoupled the Medicaid Continuous Coverage requirement, also known as Protected Medicaid, from the Public Health Emergency. This requirement is set to end April 1, 2023.
Unwinding is a term used to describe the process of re-evaluating everyone who is on Protected Medicaid and either confirming their Medicaid eligibility or transitioning them off the Medicaid program.
Starting in February 2023, consumers will begin to receive notices about completing their re-evaluations with the Department of Health and Welfare. The Department of Health and Welfare will send 30,000 notices each month until all Idahoans who were covered under Protective Medicaid have been notified.
Idahoans who are no longer eligible for Medicaid may be eligible for a tax credit and can enroll in affordable health insurance through Your Health Idaho. We encourage these Idahoans to complete their application and enroll before the end date of their Medicaid program to ensure no gap in their health insurance coverage. Idahoans who do not enroll before the end of their Medicaid coverage will be granted a 60-day Special Enrollment Period during which they may apply for a tax credit and enroll.
Your Health Idaho has established an expedited approval process to help consumers quickly enroll in coverage after their Protected Medicaid ends. Consumers can self-attest to the loss of Medicaid during the unwinding period and up to 60 days after, which will be validated against the Department of Health and Welfare’s records. Those who can’t be validated against the Department of Health and Welfare’s records will be required to provide documentation to support that they had a Qualifying Life Event (QLE) after they are enrolled.
Consumers will receive a notice from the Department of Health and Welfare notifying them that their re-evaluation is due. When you receive this notice, you can log into Idalink and complete your re-determination online or over the phone by calling the Department of Health and Welfare at 877-456-1233.
Yes, if you have a change in circumstances, it should be reported immediately. If you report a change, you will likely need to do your re-evaluation before the change will be processed. For an urgent change, such as adding a newborn, call the Department of Health and Welfare at 877-456-1233 to go through the re-evaluation process right away.
Your Health Idaho will be reaching out to consumers by email, text, and letters.
You can apply at any point during the re-evaluation process, but Your Health Idaho encourages Idahoans to complete their re-evaluation with the Department of Health and Welfare before applying with Your Health Idaho. To ensure there is no gap in coverage, enrolling before your Medicaid end date is recommended. If you do not enroll before your Medicaid end date, you will have a 60-day Special Enrollment Period (SEP) from your end date, to apply and enroll in coverage.
We recommend completing the re-evaluation process with the Department of Health and Welfare before applying with Your Health Idaho. Once the re-evaluation is complete, you will either receive a notice from Your Health Idaho which will include an access code, or you will receive a notice that your Medicaid has been discontinued by the Department of Health and Welfare. If you receive an access code visit YourHealthIdaho.org and enter the access code to start your application process. If you have not received an access code, go to Login > Create an Account to begin the process. For more detailed information and additional guidance on filling out the application, visit YourHealthIdaho.org/end-of-protected-medicaid/ for step-by-step instructions.
The event date is the last date of your Medicaid coverage. This is typically the last day of the final month of coverage.
Your children’s continued CHIP protection will depend on the type of CHIP your children are on. In Idaho, CHIP protection rules will remain in place, but they do vary by program. For questions about specific CHIP programs, please contact the Idaho Department of Health and Welfare at 877-456-1233.