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In March 2020, the Ohio Department of Medicaid (ODM) made a number of operational changes to its Medicaid program in response to the COVID-19 public health emergency (PHE). These changes included taking advantage of the flexibilities offered to states such as increasing service limits for home-and community-based waiver services, expanding telehealth, and adding Health Care Isolation Centers (HCICs) as a nursing facility benefit to name just a few. Additionally, with the passage of the Families First Coronavirus Response Act (FFCRA), the federal government provided states with a 6.2% increased federal medical assistance percentage (FMAP). In exchange, states were prohibited from disenrolling members from Medicaid, even if they were found to be ineligible. This was to ensure members did not lose vital healthcare coverage during the pandemic. 

In December 2022, Congress passed the Consolidated Appropriations Act, 2023 (CAA). Per the CAA, the continuous coverage provision that prohibited states from disenrolling members from Medicaid will expire on March 31, 2023, and, as a result, states will once again resume routine eligibility operations. Ohio will resume its normal operations on February 1, 2023. This will cause some Ohio Medicaid members to be disenrolled from the program, with the first round of termination letters being mailed to those who are no longer eligible beginning in April 2023. Given the termination of the continuous coverage provision, it is critical that Medicaid members take the necessary steps to update their contact information, respond to requests for information (including renewal packets), or transition to other coverage if they are no longer eligible for Medicaid. 

Key information for Medicaid members and stakeholders/partners is included in the dropdowns below.

Upcoming stakeholder webinars on Appendix K flexibilities

ODM, Department of Developmental Disabilities (DODD), and Department of Aging (ODA) invite you to an open discussion on the Home- and Community-Based Services (HCBS) 1915(c) waiver flexibilities implemented through Appendix K during the federal COVID-19 public health emergency. 

There are two webinars scheduled to solicit feedback from individuals with lived experiences and any recommended changes to the programs. Your feedback will be considered as the agencies work together to identify which flexibilities will continue past November 2023. 

Webinar One: Nursing Facility-Based Waiver Participants and Stakeholder Advocacy Groups

Webinar Two: Developmental Disability-Based Waiver Participants and Stakeholder Advocacy Groups

Information for Medicaid members

Now that the federal government has announced a return to routine eligibility operations, it is critical that you:

  1. 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 our dropdown menu

    • Online. Members with an existing Ohio Benefits Self-Service Portal (SSP) account can report changes online at 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. 

  2. 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.

  3. 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. 

As Ohio resumes routine eligibility operations, it is critical that Ohio’s Medicaid members take necessary steps to ensure continued health coverage for themselves and their families to allow for a smooth transition. Our partners will play a key role in informing Medicaid members about the steps they need to take to renew their coverage or transition to other coverage if they’re no longer eligible for Medicaid.

To support these efforts, ODM has developed a Partner Packet with key messages and templates you can use as you communicate with Medicaid members. Sample materials include:

  • Drop-In Articles – brief stories suitable for use on websites and in newsletters and bulletins
  • Flyers – printable flyers, great for posting in your business location or distributing by including it in packaging (such as attached to prescription medicine bags) or as a handout
  • Social Media – graphic posts that can be used on your own social media accounts
  • Text Messages – short reminder messages to encourage updating contact information
  • Medicaid Member Mailers – direct messaging that is suitable in an email or U.S. postal format
  • On-Hold Messages – messaging to be provided to Medicaid members when on hold about the impending end of the continuous coverage provision and ways they can best be prepared
  • Rack Card – printable rack card in the standard size (4x9 inches)   

Key messages to communicate to members, which are detailed further in the Partner Packet, include:

  1. Communicate to Medicaid members the importance of updating their contact information and responding to requests for information.
  2. Share with members the importance of responding to their renewal packets
  3. Ensure Medicaid members take the necessary steps to transition to other coverage if they’re no longer eligible for Medicaid
  4. Children may be eligible for coverage even if their parent/legal guardian is no longer eligible