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Medical Doctor; Medicaid; Healthcare

Medicaid Unwinding: SEP is Coming

The Centers for Medicare and Medicaid Services (CMS) has announced a Marketplace Special Enrollment Period (SEP) for qualified individuals and their families who are losing Medicaid coverage due to the end of the continuous enrollment condition – also known as “Unwinding.” 

Medicaid Renewals Resume

During the COVID-19 Public Health Emergency (PHE), the Kentucky Department for Medicaid Services (DMS) ensured all Medicaid beneficiaries kept their coverage. As a result, DMS stopped all annual renewals. 

But soon, DMS will begin annual renewals for Medicaid members. Your clients may be at risk of losing Medicaid coverage if they cannot be reached. Here you can find a client-facing communication to answer frequently asked questions and instructions for updating their information. 

Unwinding SEP Opportunity

This SEP, referred to as the Unwinding SEP, will allow individuals and families in Federally-facilitated Marketplace (FFM) states, to enroll in Marketplace coverage. CMS will update Marketplace enrollment platforms like HealthCare.gov and Direct Enrollment/Enhanced Direct Enrollment pathways. This is so that Marketplace-eligible consumers who submit a new application or update an existing application between March 31, 2023, and July 31, 2024, and attest that they have lost Medicaid or the Children’s Health Insurance Program (CHIP) coverage between these dates, are eligible for the Unwinding SEP.

Consumers who are eligible for the Unwinding SEP will have 60 days after they submit their application to select a plan with coverage that starts on the first day of the month after they select a plan.

Keep Clients in the Know

Please let your clients know that they need to update their contact information as soon as possible and keep it updated, so Kentucky Medicaid can reach them when it is time to renew.

The full FAQ can be found at the same link shared at the beginning of the article.

For any questions you may have or assistance you may need with this Unwinding, please contact a member of our AgentLink team to help!

Filed Under: Medicaid Tagged With: CMS, DMS, Medicaid, SEP, Special Enrollment Period, Unwinding

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