Fact Sheet 0423
Understanding Medicaid “Unwinding” 2023
What is the Medicaid continuous coverage requirement and how is it changing?
In response to the COVID-19 public health emergency Congress enacted the Families First Coronavirus Response Act in 2020. The Act included a provision that required states to provide continuous enrollment for Medicaid beneficiaries. As a result, individuals who were enrolled in Medicaid as of March 2020, or later, were kept enrolled in Medicaid regardless of if they completed an annual redetermination, or if they experienced changes that otherwise would have affected their eligibility (such as change in income).
In December of 2022, Congress passed a bill that set March 31, 2023 as the end date for the continuous coverage requirement. The end of the requirement means that as of April 1, 2023 states began “unwinding” the provision by resuming normal Medicaid processes for redetermination and disenrolling individuals determined no longer eligible. States were given a timeline of up to 14 months to redetermine eligibility for all of their Medicaid enrollees.
What is Virginia’s plan for Medicaid unwinding?
Virginia will conduct renewals for its entire Medicaid and FAMIS population over a 12-month period, starting April 1, 2023. Some members will have their renewal completed automatically if the agency is able to verify the individual’s eligibility via electronic records. For those not redetermined automatically through electronic verifications, the agency will mail a renewal packet to the member’s address on file.
What actions do I need to take to keep my Medicaid coverage?
- Update your contact information on file. You can update your information by calling Cover Virginia at 1-855-242-8282, by visiting commonhelp.virginia.gov, or by contacting your local Department of Social Services office.
- Routinely check your mail and messages.
- Complete and return the renewal packet. If you receive a renewal packet, read it and any accompanying notices carefully to see what is requested and the due date(s).
- Continue to monitor your mail and messages, and provide any and all additional documentation requested for completing your renewal.
What should I do if I lose my Medicaid coverage?
Review your determination letter to see the reasoning for the termination of coverage.
- If it’s due to not returning your renewal packet or for not providing requested verifications, you have a 90-day grace period from the date of termination to return the documents and have your eligibility redetermined.
- If it’s due to no longer meeting Medicaid eligibility criteria, then you may be eligible for coverage via the Federal Marketplace. Visit www.HealthCare.gov.
For more information on your renewal, contact your local Department of Social Services office.