2023 Return to Routine Medicaid Eligibility Operations
Since January 2020, every Ohioan who enrolled in Medicaid has received continuous Medicaid coverage without disenrollments due to ineligibility, unless that Ohioan moved to a different state, asked to be removed from Medicaid, or passed away.
Now, because of federal actions in December 2022, Medicaid eligibility is returning to routine operations and every Medicaid member will undergo an eligibility review before March 2024.
Help us spread the word about these changes and what Medicaid enrollees can do now to prepare!
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I’ve heard changes are coming, what can I do now to keep Medicaid?
There are a few steps you can take now to get ready for upcoming changes:
Keep your contact information up to date so you can receive notices in the mail. You can update your contact information by:
Calling 1-844-640-6446. Help is available Monday through Friday 8 a.m. to 4 p.m. ET.
In person or by mail at your local CDJFS. You can find your CDJFS by selecting your county from the dropdown at https://medicaid.ohio.gov/home/update-contact-info/select-county-dropdown.
Online. Members with an existing Ohio Benefits Self-Service Portal (SSP) account can report changes online at https://ssp.benefits.ohio.gov. After logging in, click the “Access my Benefits” tile, then click “Report a Change to my Case” from the dropdown and follow the prompts.
Check your mail and respond to renewal letters or requests for information immediately. While some renewals can be completed without a need to contact the member, some renewals will require members to respond to mail. If you receive a letter stating that it is time to renew, or that your CDJFS needs more information, you should respond right away. If you do not respond to renewal letters or requests for information, you risk losing coverage even if you still meet the eligibility criteria for Medicaid.
I have lost my Medicaid coverage, what do I do now?
If you believe you are still eligible for Medicaid and were wrongfully disenrolled, follow the steps to appeal the decision that are outlined in your termination notice. An appeal must be submitted within 15 days of the termination notice date to continue to have coverage throughout the appeal process.
For assistance submitting an appeal, contact your local Legal Aid or county Job and Family Services Office.
If you believe you are NOT eligible for Medicaid and were disenrolled, assistance with enrolling in the health insurance Marketplace is available from:
Get Covered Ohio: (833) 628-4467, https://getcoveredohio.org/
REMEMBER that children may remain eligible for Medicaid even if the parents are not. Make sure your children do not lose the Medicaid coverage they are eligible for. For additional information on Healthy Start and the Children’s Health Insurance Program, contact your county Job and Family Services office.
I received a Medicaid renewal packet in the mail, what do I do?
Your county Job and Family Services office might need additional information to process your case. If you receive a packet requesting additional information, be sure to respond right away.
If you have questions about what actions are needed, contact Get Covered Ohio at (833) 628-4467 for assistance, or contact your county Job and Family Services office.
I was told my Medicaid coverage was renewed, what do I need to do?
If you received a notice that your Medicaid coverage has been successfully renewed, no further action should be needed from you. If you’re not sure if any action is needed, contact Get Covered Ohio at (833) 628-4467 for assistance, or contact your county Job and Family Services office.
I received a notice for the Next Generation of Managed Care AND for disenrollment. I’m confused, why did I receive these notices?
In February, three new Medicaid insurance plans were launched. Ohio Medicaid eligibility reviews also began in February. Even if you just started coverage with a new insurance company, you will still need to undergo an eligibility review with your county Job and Family Services office. Be sure to respond to any requests for additional information as soon as possible.
I got a new Medicaid plan but I’m not happy with it, what do I do?
Ohio Medicaid’s three new insurance plans that launched in February are not related to the re-start of Medicaid eligibility reviews. However, if you’re unhappy with the insurance company that you switched to, you have until May 1, 2023 to select a new insurance plan. Make a new plan selection by using the Ohio Medicaid Consumer Hotline Portal at www.ohiomh.com or by contacting the Ohio Medicaid Consumer Hotline at 800-324-8680.
You can also switch to a different Medicaid managed care plan during the annual open enrollment period in November.
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What is the Marketplace?
The insurance Marketplace, hosted at HealthCare.gov, was created by the Affordable Care Act to make insurance coverage available to those who do not have health insurance available through Medicaid, Medicare, or their place of employment. Consumers can compare insurance plans and prices on the Marketplace.
Are subsidies available for insurance premiums on the Marketplace?
Yes, subsidies are available to reduce monthly premiums and other out of pocket costs, like co-pays, deductibles and co-insurance. Recent federal law changes made these subsidies more generous, so even if you’ve found Marketplace coverage too expensive in the past, it is worth shopping for a plan now. To apply for subsidies, complete the application at healthcare.gov and/or contact Get Covered Ohio at (833) 628-4467 for assistance.
Marketplace Special Enrollment Period
Under a recently-announced Special Enrollment Period, anyone who loses Medicaid coverage can enroll in the Marketplace, even if they lose coverage outside the typical open enrollment period.
The Special Enrollment Period will run from March 31, 2023 until July 31, 2024.
What does the Special Enrollment Period Change?
If Medicaid members know they will be losing their coverage, they can submit an application for Marketplace coverage up to 60 days before their last day of Medicaid coverage.
Marketplace coverage for former Medicaid members will begin the first day of the month following plan selection.
Is Marketplace coverage retroactive?
No, it is not. This means that a person cannot lose Medicaid coverage, seek out care, and then apply for Marketplace coverage to pay for care after that care has been completed. Marketplace coverage must be active at the time of seeking out health care.
Navigators and Assisters
Navigators and enrollment assisters are available throughout Ohio to help Ohioans navigate the renewal process, access Marketplace coverage, or re-enroll in Medicaid if needed. Contact Get Covered Ohio to find a navigator near you:
Get Covered Ohio: (833) 628-4467, https://getcoveredohio.org/
Did you lose Medicaid coverage but need health care now?
Find a Community Health Center near you: https://findahealthcenter.hrsa.gov/
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To prepare for the return of routine eligibility operations, here are some important steps to take:
Keep your contact information up to date. When it’s time to renew, or if Medicaid needs more information to continue a member’s coverage, your County Department of Job and Family Services (CDJFS) mails a letter. It is imperative that your contact information is up to date so you don’t miss out on important notices. You can update your contact information by:
Calling 1-844-640-6446. Help is available Monday through Friday 8 a.m. to 4 p.m. ET.
In person or by mail at your local CDJFS. You can find your CDJFS by selecting your county from the dropdown at https://medicaid.ohio.gov/home/update-contact-info/select-county-dropdown.
Online. Members with an existing Ohio Benefits Self-Service Portal (SSP) account can report changes online at https://ssp.benefits.ohio.gov. After logging in, click the “Access my Benefits” tile, then click “Report a Change to my Case” from the dropdown and follow the prompts.
Check your mail and respond to renewal letters or requests for information immediately. While some renewals can be completed without a need to contact the member, some renewals will require members to respond to mail. If you receive a letter stating that it is time to renew, or that your CDJFS needs more information, you should respond right away. The CDJFS needs to hear from you to review your Medicaid eligibility. If you do not respond to renewal letters or requests for information, you risk losing coverage even if you still meet the eligibility criteria for Medicaid.
You can manage your Medicaid account, complete renewals, upload documents, and find out the status of your coverage by logging into your Ohio Benefits Self-Service Portal account at ssp.benefits.ohio.gov.
For additional questions, help is available in person or via phone at your CDJFS.
You can also call 1-844-640-6446. Help is available Monday through Friday 8 a.m. to 4 p.m. ET.
Take the necessary steps to transition to other coverage if you're no longer eligible for Medicaid.
If you are notified you no longer qualify for Medicaid, you may be able to buy low-cost health coverage through the federally facilitated Marketplace at healthcare.gov. Losing Medicaid or CHIP coverage is a Qualifying Life Event (QLE), which allows you to enroll in a Marketplace plan outside of the Open Enrollment Period.
If you need help understanding your options, trained, licensed insurance navigators are available at no cost to you. Contact Get Covered Ohio for free, unbiased assistance. Go to getcoveredohio.org or call 1-833-628-4467. Insurance navigators can help in person, online, or over the phone.
PLEASE NOTE: even if you are no longer eligible for Medicaid, your child may be eligible for coverage. Ohio Medicaid offers a Program called “Healthy Start” that is available to insured or uninsured children (up to age 19) in families with income up to 156% of the federal poverty level. The Children’s Health Insurance Program (CHIP) is also available to uninsured children (up to age 19) in families with income up to 206% of the federal poverty level. For additional information, contact your CDJFS.
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End of Continuous Coverage Flyer
Ohio Department of Medicaid Communications Packet
Social Media Sample 1
Starting with Medicaid renewals due in April 2023, all Medicaid members will have to renew their health coverage. If you receive a notice that you are no longer eligible for Medicaid and need help finding new coverage, visit getcoveredohio.org or call 1-833-628-4467.
Social Media Sample 2
Are you an Ohio Medicaid member? Be sure your contact information is up to date, so you don’t miss important updates about your health insurance. If you get a letter from Medicaid or your County JFS office, be sure to respond.
Visit benefits.ohio.gov or call 1-844-640-6446 to update your contact information.
Newsletter Language
If you’re a Medicaid member, take steps now to prepare for upcoming changes!
Since March 2020, the Ohio Department of Medicaid has followed COVID-era requirements to not disenroll any Medicaid members to ensure members did not lose vital healthcare coverage during the pandemic.
Now, the federal government is ending this requirement and all states are returning to normal operations this month. Medicaid members will be disenrolled if they no longer meet the eligibility requirements, or if they do not respond to renewal packets and requests for information sent in the mail.
Make sure your contact information is up to date so Medicaid can reach you! You can update your contact information by:
Calling 1-844-640-6446. Help is available Monday through Friday 8 a.m. to 4 p.m. ET.
In person or by mail at your local CDJFS. You can find your CDJFS by selecting your county from the dropdown at https://medicaid.ohio.gov/home/update-contact-info/select-county-dropdown.
Online. Members with an existing Ohio Benefits Self-Service Portal (SSP) account can report changes online at https://ssp.benefits.ohio.gov. After logging in, click the “Access my Benefits” tile, then click “Report a Change to my Case” from the dropdown and follow the prompts.
If needed to review your eligibility, you can expect to receive a renewal packet for the month that you originally enrolled in Medicaid. Be sure to respond as soon as possible. Renewal packets can be completed online at benefits.ohio.gov, in-person, by mail to your local County Department of Job and Family Services, or by phone at 1-844-640-6446.
If you’re no longer eligible for Medicaid coverage, you may be eligible for a low-cost, quality health plan on the Marketplace, also known as Healthcare.gov. If you want help reviewing your options, trained, licensed insurance navigators are available at no cost to you. Contact Get Covered Ohio for free, unbiased assistance. Go to getcoveredohio.org or call 1-833-628-4467. Insurance navigators can help in-person, online, or over the phone.
TV Screen Ads
These PDFs can be added to tv screens in waiting rooms, lobbies, and more, to spread the word:
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Medicaid member renewal will take place in the same month of the year that the member initially enrolled in Medicaid. Here is a sample timeline, using an April renewal month as an example:
March 1st (1st day of month prior to renewal month): Renewal packets mailed to members who need to take action
March 3rd (3rd day of month prior to renewal month): Robocalls to ask for renewal response
March 21st (3rd week of month prior to renewal month) Reminder notices mailed asking for renewal response
March 31st (Last day of month prior to renewal month): Renewal packets due
April 13th (Mid-month of the renewal month): Notice of Action sent to members that are no longer eligible
April 30th (Last day of renewal month): Coverage terminated
May 1st (1st day of month following renewal month): First day without Medicaid coverage
Page Last Updated: Wednesday, November 15, 2023