During the Public Health Emergency (PHE) due to COVID-19, states had to follow federal requirements around the “Medicaid Continuous Enrollment Condition”, and were therefore not allowed to remove individuals from their Medicaid programs. However, in March, 2023 the Consolidated Appropriations Act unlinked the continuous enrollment condition from the PHE, which allowed states to begin redetermining Medicaid recipients’ eligibility, and potentially removing them from the program. North Carolina began our redetermination process on April 1, 2023; this is called the “Continuous Coverage Unwinding” or “Medicaid Unwinding”.
Unfortunately, more North Carolinians than expected have lost Medicaid coverage during the Continuous Coverage Unwinding due to “procedural terminations”. This means that these individuals may still be eligible for Medicaid, but just need to update certain information with their local DSS.
Some may have received “Medical Assistance Renewal Notice” or “Request for More Information” letters from their local DSS and not known what to do about them. Others may not have received anything, because their DSS does not have their up-to-date mailing address.
There’s also concern that some people who received termination letters from Medicaid won’t try to re-enroll because they feel they’re healthy and don’t need coverage. We highly encourage all individuals to maintain the health coverage that is available to them so they don’t have to seek coverage in a crisis, and have access to the care they need and deserve.
Community Based Organizations can help their clients and community members understand how to maintain their Medicaid coverage, or seek other affordable coverage several ways:
Inform Them the “Unwinding” Is Happening
Many people still don’t know the Continuous Coverage/Medicaid Unwinding is happening, or that it affects them. You can help spread the word about the Unwinding with pre-made materials from NC DHHS & CMS:
- NC DHHS CCU Unwinding Toolkit
- NC Medicaid Recertification Video – 15s
- NC Medicaid Recertification Video – 30s
- NC Medicaid Recertification Video – 60s
- All Hands-on-Deck: Keeping People Covered As States Restart Routine Medicaid Renewals
- Medicaid and CHIP Eligibility Renewals: A Communications Toolkit
Make Sure Medicaid Recipients in Your Community Know 3 Key Messages:
- Update their current contact information with their local DSS
- Check their mail and open all letters from DSS
- Sign Up For an Enhanced EPASS Account – This lets you update your contact and other Medicaid information online without having to call your local DSS.
Let Them Know There are Options if their Medicaid has Been Terminated
You can help community members know what steps to take if their Medicaid has been terminated by directing them to FREE resources, like the ones below:
Who to Contact if…
I received a letter from Medicaid/DSS that I don’t understand
- Your Local DSS – Find Your Local DSS Number
- NCMedHelp.org / NCMedHelp.com
- NC Medicaid Ombudsman
My Medicaid was terminated, but I think I should be eligible:
I don’t qualify for Medicaid, but might qualify for financial help through the Health Insurance Marketplace:
- Get Covered Connector – Find local help understanding your options through the Marketplace
I don’t qualify for Medicaid, but I may qualify for Medicare:
Seniors’ Health Insurance Information Program – Find a local SHIIP Counselor to help you understand your Medicare options
I don’t qualify for any affordable health insurance options:
- Find a Health Center – Find a local Federally Qualified Health Center that could offer low cost sliding-scale payment options
- NC Association of Free & Charitable Clinics
- NC Networks of Care for Low-Income, Uninsured
What About Medicaid Expansion?
Although Medicaid Expansion was signed into law by Governor Cooper in March 2023, its implementation cannot begin until the NC General Assembly either passes a state budget or “de-couples” expansion from the budget. At this time, the earliest date an eligible individual may be able to enroll in the “Expanded” Medicaid Program is October 1, 2023.
NC DHHS Resources
- NC Medicaid Recertification Page
- NC Medicaid Beneficiary Webpage
- NC Medicaid Beneficiary Help Center
- Sample Medical Assistance Renewal Notice | Spanish
- Sample Request for More Information | Spanish
- CMS Resources
- Partner Education on Medicaid and CHIP Continuous Enrollment Unwinding Webinars
- HHS Announcement of State Flexibilities to Minimize Coverage Loss
Protecting Immigrant Families
If you have questions about how your CBO can help your community understand the Medicaid/Continuous Coverage Unwinding, Marketplace and other low cost healthcare options, contact Erin Storie at: firstname.lastname@example.org