Medicaid changes: Here’s what New Yorkers need to know

Changes are coming to Medicaid, and millions of people are at risk of losing their coverage.

This year, every state will be checking the eligibility of everyone who is enrolled in the program. That’s about 84 million people across the country. Of those, nearly 8 million are New Yorkers.

People can become ineligible for Medicaid if they make too much money to qualify, get health care coverage through an employer or move to a new state.

States used to check eligibility regularly and kick off people who were ineligible, but the practice was suspended in 2020 when the COVID-19 pandemic hit. Now states are checking eligibility for the first time in three years.

Here’s what you need to know if you rely on Medicaid for health care coverage:

1. The state will mail a renewal form to your home. You also will get a reminder by phone, text message or email to fill out the document. You can prepare ahead of time by making sure Medicaid has your accurate contact information.

The first renewal forms will be sent out in New York City in March and in the rest of the state in April.

2. Fill out the renewal form with your most up-to-date personal information, including home address, phone number, email, income and household size.

3. You will have at least 30 days to fill out the form.

4. If you fail to fill out the form, the state can remove you from Medicaid. People who are removed from Medicaid in New York can request a review or a hearing.

5. If you lose your Medicaid coverage, look at the Affordable Care Act’s marketplace for health care coverage for low-priced options. There will be a special enrollment period for those who lose their Medicaid eligibility that starts March 31 and lasts through July 31, 2024. You will have up to 60 days to enroll.

Some options on the Affordable Care Act’s marketplace may cost less than $10 a month, but they may have higher out-of-pocket expenses and co-pays. Check to see that the insurance plans offered through the marketplace will cover your doctors.

Also, children may still qualify for Medicaid or for the Children’s Health Insurance Program. Known as CHIP, the program is for children in families that make too much money qualify for Medicaid but not enough to afford private health insurance.

Between 80% and 90% of children will remain eligible for one of the two programs, experts say.

To stay informed, sign up to receive SMS/MMS Text alerts from NY State of Health for updates. To subscribe, text START to 1-866-988-0327.

New Yorkers with Medicaid questions can call the State of Health Customer Service Center at 1-855-355-5777 or check the NY State of Health and the Department of Health’s Medicaid websites.