December 11, 2024
Today, the Maine Department of Health and Human Services (DHHS) released an update on the conclusion of MaineCare (Medicaid) eligibility reviews after the COVID-19 Public Health Emergency, known as "unwinding." At the conclusion of the 15-month unwinding period (from May 2023 through October 2024), the Department's efforts have resulted in over 345,000 MaineCare members successfully renewing and retaining coverage. This includes the nearly 30 percent who were renewed automatically without having to complete a renewal form, through electronic verification tools and income data already available to DHHS, called passive or "ex parte" renewal.
Maine's renewal plan executed on four key components:
- Procurement and deployment of additional trained temporary staffing to assist with increased mail and phone activities.
- Temporary suspension of disenrollment for the procedural reason of not returning a renewal until July 2024, when technology updates were implemented to allow MaineCare to conduct passive renewals on an individual (rather than household) level. Passive renewal allows for MaineCare benefits to be renewed for individuals without a reapplication process if their eligibility requirements continue to be met. This process includes verifying continued eligibility through electronic tools and data already available to the department.
- A robust communication and outreach strategy that ensured continued awareness for all MaineCare recipients and health care providers about unwinding activities and progress
- Engagement with community-based organizations working on the ground across the state to educate and assist MaineCare members with renewals, or with transitions of coverage to plans on CoverME.gov.
MaineCare members who completed their renewal and were determined ineligible for MaineCare during the unwinding process, and who do not have another source of affordable coverage, such as Medicare or insurance through their employer, are eligible to enroll in coverage at CoverME.gov, Maine's Health Insurance Marketplace. Those individuals are likely eligible for financial assistance to help lower plan premiums and out-of-pocket costs on CoverME.gov. Consumers should visit CoverME.gov to create or log into an account and submit or review their application. Once their application is complete, CoverME.gov will determine if they are eligible for financial assistance to lower their CoverME.gov premium and out-of-pocket costs.
Maine DHHS' Office for Family Independence (OFI) will continue to ensure that members can access assistance with their MaineCare renewals by continuing temporary increases to call center capacity to help with phone volume and maintaining changes, such as providing a MaineCare menu option and offering estimated wait times and callback options to speak with an eligibility specialist.