January 23, 2024
Today, the Maine Department of Health and Human Services (DHHS) released an update on the resumption of MaineCare (Medicaid) eligibility reviews after the COVID-19 Public Health Emergency, known as “unwinding.” During the first eight months of the unwinding period (from May to December, 2023), the Department’s efforts have resulted in over 204,000 MaineCare members successfully renewing or retaining coverage. This includes nearly 30 percent who were renewed automatically, without having to complete a renewal form, through income data already available to DHHS, called passive or “ex parte” renewal.
Due to updated federal guidance, Maine has changed its MaineCare renewal plan. To comply with federal policy, DHHS suspended disenrolling members for the “procedural” reason of not returning their renewal form to prevent individuals and families from losing coverage unnecessarily as improvements are made to Maine’s passive renewal system. Technology updates to allow MaineCare to conduct passive renewals on an individual (rather than household) level will be implemented in July 2024, with unwinding renewal determinations completed by October 2024.
MaineCare members who complete their renewal and are 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, can use a Special Enrollment Period (SEP) to enroll in coverage at CoverME.gov, Maine’s Health Insurance Marketplace. Those individuals are likely eligible for financial savings to buy a plan on CoverME.gov. Consumers should visit CoverME.gov to create or log into an account, submit or review their application, and select “Recently lost MaineCare” from the list of Special Enrollment Periods. When they complete the application, CoverME.gov will determine if they are eligible for financial assistance to lower their CoverME.gov premium or out-of-pocket costs.
The Office for Family Independence (OFI) has also been implementing changes to improve call center performance, to ensure that members can access assistance with their MaineCare renewals. This includes temporary increases to call center capacity to help with phone volume; adding a MaineCare menu option, allowing callers to route directly into the MaineCare queue; and offering estimated wait times and callback options to speak to an eligibility specialist.
MaineCare members who have not yet gone through the eligibility review process should take two important steps to stay covered:
- Update their current contact information with MaineCare, including address, email and phone number. Members can call 1-855-797-4357 and press option 1 to update contact information through an automated system or visit MyMaineConnection.gov. Stay Connected to Stay Covered!
- Be on the lookout for an envelope with a blue block on it, which contains the MaineCare renewal notice: If it’s blue, it’s time to renew! Members who signed up for e-noticing on My Maine Connection will receive their notice electronically and will not receive the envelope. Whether a member receives their renewal form by mail or e-notice, they will need to complete and return it by the deadline. Members who are determined to be eligible through the passive renewal process will receive a notice that their coverage has been renewed for 12 months and will not be required to fill out a renewal form.
MaineCare is unlike other health insurance in that anyone who needs it can apply at any time, without waiting for an open enrollment period or qualifying life event.
The Department provided these unwinding updates today to the Legislature’s Health and Human Services Committee. The full presentation is available here (PDF).