Pennsylvania residents getting health insurance through Medicaid have to reapply, state secretary says

An important deadline is looming for millions of Pennsylvania residents who get health insurance through Medicaid that, if missed, could result in losing coverage.

But even if residents find themselves no longer eligible for Medicaid, there is another way to keep coverage.

Dr. Val Arkoosh, secretary of the state Department of Human Services, delivered the message during an appearance Wednesday at Wesley Family Services’ Pioneer Apartments in New Kensington. It coincided with an open house for Wesley’s new wellness center at the apartment and office building.

Arkoosh said those attending could help spread the word so those eligible to receive Medicaid can remain enrolled.

“During the pandemic, we had the ability to keep anyone who was enrolled in Medicaid enrolled in Medicaid no matter what. But the pandemic has ended,” she said. “The federal government has required that we go back to our pre-pandemic processes of once a year having to redetermine whether or not an individual still is eligible to receive health care through the Medicaid program.”

Arkoosh said 3.5 million Pennsylvanians get health care through Medicaid and are at risk of losing it or having a gap in coverage.

The process started April 1 and will take an entire year to complete, she said.

“Nobody is going to lose their health insurance automatically,” she said. “Every single person will be given an opportunity to submit their information and make sure that they still qualify, and if they don’t still qualify, we have a plan for that, too.”

All residents covered by Medicaid or CHIP, the Children’s Health Insurance Program, will have a chance to complete a renewal or update their information in coming months, Arkoosh said.

“By completing a renewal and submitting it, we can figure out if you still qualify to get your health care through Medicaid,” she said. “And if you don’t, we will automatically and securely connect you to other sources of coverage.”

Those other sources include Pennie, the state’s health insurance exchange that replaces the federal marketplace at healthcare.gov.

“You can buy health coverage from a variety of different sources directly from an insurance company, but Pennie is the only way that you receive financial savings to reduce the cost of your monthly payment or out-of-pocket cost,” said Chachi Angelo, director of external affairs for Pennie. “At Pennie, you can compare health plans across different companies and find which best works for you, your family, and what best works for your wallet.”

Angelo said it’s done through a tax credit only available through Pennie, where monthly payments are based on income.

“Pennie is designed to pick up where Medicaid leaves off,” he said. “If you make too much for Medicaid, chances are that you will receive significant savings through Pennie.”

Of more than 20,000 people already enrolled after losing Medicaid coverage, Angelo said about half are paying $50 per month, while one in five is paying less than $1 per month for a $500-per-month plan.

“Many in this area have already experienced the peace of mind that comes with Pennie coverage,” he said. “Over 10,000 individuals in Westmoreland County signed up for 2023 coverage.”

For residents to get information about their Medicaid renewals by mail, Arkoosh said her department needs to have up-to-date contact information. That can be updated, if needed, online at dhs.pa.gov/staycovered, through the Compass smartphone app, or by telephone at 877-395-8930.

Those who don’t know their renewal dates can check them online, through the app or by phone.

“When the Pennsylvania Department of Human Services has your correct contact information, we will contact you with plenty of time before your renewal is due,” she said. “Once you know your renewal date, you will be able to make sure that you complete that renewal on time.”

Those who miss their renewal deadline can return their packet late, she said.

“You can also appeal a decision that we made. If you think we made a mistake, you have every right to appeal our decision, and we encourage you to do that,” Arkoosh said. “We just want to make sure that we keep every Pennsylvanian covered.”

Those who think they may no longer be eligible because of a change in circumstances, such as a job with better pay but no health insurance, still should submit a packet, Arkoosh said.

“If, indeed, you’re not eligible for Medicaid any longer, we will then send your information over to Pennie. You don’t have to start over,” she said. “You’ll be given a login for a new account on the Pennie system, and then you can shop for health insurance plans on our Pennsylvania health insurance exchange.”

Arkoosh urged state residents on Medicaid to check their renewal dates, make sure the state has their current contact information, and, as their renewal dates approach, look for information in the mail from the Department of Human Services.

“This is so important because this is about your health, the health of your family, the health of your loved ones, your friends, your neighbors,” she said. “We don’t want anyone to go without coverage.”