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Medicaid Redetermination

Medicaid Redetermination

Nationwide, Medicaid beneficiaries will have to renew their coverage starting this year to comply with federal legislation. In Michigan, annual renewals will begin again in June 2023.

If you receive notice that you or a family member are no longer eligible for Medicaid or MIChild benefits, don’t worry, you have other options including options for low or no-cost coverage:

  • Purchasing a plan on the Health Insurance Marketplace. Thanks to savings recently put in place by the federal government, many Michiganders are eligible to buy a Marketplace plan for less than $10 per month. Free local enrollment help is available in-person, over the phone, or by email to help you choose the plan that meets your needs and budget.

    Losing Medicaid coverage is a qualifying life event, allowing you to enroll in a Marketplace plan outside of the normal open enrollment period. You can enroll as early as 60 days before you expect to lose coverage. People who are signing up for a Marketplace plan because they lost Medicaid coverage have up to 60 days to select a plan after submitting a Marketplace application – but signing up right away reduces the risks that come from a lapse in coverage.

    To shop and compare available health plans, visit HealthCare.gov or call 800-318-2596 (TTY: 855-889-4325). For free local help, visit LocalHelp.HealthCare.gov.

  • Enrolling in employer-sponsored health coverage through your job. Many employers offer health insurance to their employees, and those plans often offer a special enrollment period, generally at least 30 days, for employees who experience a qualifying life event, such as losing Medicaid coverage. Contact your employer’s benefit office or human resources department to ask about enrolling in your employer’s health plan.

  • Enrolling in Medicare. Eligible seniors who lose their Medicaid coverage can enroll in Medicare Parts A and B up to six months after their Medicaid coverage ends. For Medicare Advantage Plans (also known as Part C), newly enrolled Medicare beneficiaries can sign up for a plan within three months after the start date of their Medicare coverage.   

    Michiganders who turned 65 during the COVID-19 Public Health Emergency and missed their initial enrollment window may also sign up for a Medicare Supplement plan, thanks to a recent order from the Michigan Department of Insurance and Financial Services.

    To enroll in Medicare or shop for a Medicare Advantage or Medicare Supplement plan, visit Medicare.gov or call 800-772-1213 (TTY: 800-325-0778). Michigan Medicare Assistance Program counselors also are available to provide free help with Medicare enrollment. For more information visit MMAPInc.org or call 1-800-803-7174 to speak with a counselor.

Having health insurance is important, not just for when you are sick or hurt, but also to help you stay healthy and avoid big medical bills. It is important that you take action to get the coverage you need to protect yourself and your family.

For questions about purchasing a health plan on HealthCare.gov, visit Michigan.gov/HealthInsurance, or call the Michigan Department of Insurance and Financial Services (DIFS) at 877-999-6442, Monday through Friday from 8 a.m. to 5 p.m.

More information about changes to food assistance and Medicaid benefits connected to the COVID-19 Public Health Emergency can be found at Michigan.gov/2023BenefitChanges.

To help stakeholders share information about coverage options with Michiganders, DIFS has prepared a toolkit that offers sample newsletter content, social media posts, and a PSA video.

Frequently Asked Questions

  • Many health insurers and plans contract with a group of facilities, providers, and suppliers to provide health care services. This group is called a network. Whenever someone changes their health coverage or plan, it is possible they may have to change doctors because their doctor is not in the new plan’s network. Before selecting a new plan, it is important to research which plans include your doctors in their network to make sure that the providers you prefer and services you need are covered under that plan.

    For more information, visit the Michigan Department of Insurance and Financial Services’ Shopping for Health Insurance webpage.

  • It is important to consider more than just the monthly premium when selecting a health insurance plan. Policies with lower monthly premiums may provide less coverage or require you to pay more out-of-pocket for health care services. You may want to estimate and compare how much you will likely pay under the options you are considering, factoring in all appointments, medications, and unexpected illnesses. You will also want to factor in available subsidies or tax credits, how much you can afford to pay out of pocket, and what your family’s needs are likely to be.

    For more shopping tips, visit the DIFS website. If you need enrollment assistance, free, local enrollment help is available at Localhelp.Healthcare.gov.

  • Many consumers may worry that buying their own health plan will be too difficult or too expensive. There are subsidies in place that can help many Michiganders get a plan for less than $10 a month and there is free local enrollment help available that can help consumers select a plan that works for their needs and budgets.

    For more information about available subsidies or to get started with enrollment, visit HealthCare.gov.

  • That is possible, depending on when your Medicaid coverage ends and when you enroll in your new Marketplace plan. That is why it is so important to look at your options early and have a plan in place. When you buy a Marketplace plan, your new coverage will typically begin on the first day of the month after you select your plan. For example, if you select a plan on August 14, your coverage will start September 1. If your Medicaid coverage ends before the start date of your new Marketplace plan, you could have a lapse, so it is important to enroll in a new plan as soon as possible.

  • Michigan employers can play an important role in helping their employees stay healthy, engaged, and on the job by communicating about the eligibility redetermination process with those who may be affected, including:

    • Encouraging employees who are Medicaid beneficiaries, or those who have Medicaid program beneficiaries in their household, to update their contact information at Michigan.gov/MIBridges. This will help the state reach them when it is their time to renew.
    • Reminding employees who receive a renewal packet from Medicaid to fill it out and return it by the due date listed on the packet. It is critical that anyone who receives a packet complete and submit the paperwork by the due date, even if participants believe they are no longer eligible, as others in the household may still be eligible for benefits. Those who do not complete and return the renewal paperwork may lose Medicaid coverage.
    • Informing their employees of employer-sponsored coverage options that are available to them if they have lost their Medicaid coverage. Employer-sponsored health plans typically offer a special enrollment period outside of the normal annual open enrollment period for employees who experience a qualifying life event, such as losing Medicaid coverage.
    • Informing their employees that high quality, affordable coverage is available at HealthCare.gov, where many Michiganders can take advantage of savings to get a comprehensive Marketplace plan for less than $10 per month. For anyone who needs assistance selecting a Marketplace health plan, free local help is available.

    More information about Medicaid eligibility renewals is available at Michigan.gov/2023BenefitChanges. For more information about coverage options, including a toolkit with sample newsletter content and social media that employers can use to share this information, visit Michigan.gov/StayCovered or call the Michigan Department of Insurance and Financial Services at 877-999-6442, Monday through Friday from 8 a.m. to 5 p.m.