Renewing Medicaid & CHIP Through Kancare
Jul 25, 2023
Are you currently enrolled in Medicaid or CHIP? You could lose coverage if you don’t take immediate action. KanCare requires you to renew your coverage every year, however, renewals have been temporarily paused since 2020 so many Medicaid members have not had to renew for three years or may have never had to renew before. If you do not renew your coverage ASAP, you could lose coverage.
The 2023 restarting of the renewal process is called “Unwinding.” It has already started, and it’s crucial for you to take action to ensure that you maintain your Medicaid or CHIP coverage this year.
Medicaid Unwinding & KanCare Renewals Overview
What Do I Need to Do?
The Medicaid renewal process with KanCare is actually quite simple. You need to:
- Ensure your contact info is up to date with KanCare so they can send you a renewal form in the mail.
- Fill out your renewal form, sign it, and mail it back to KanCare during your renewal period.
This article covers how to update your info with KanCare, what you need to do once you receive your Medicaid renewal form, and what to do if you missed your renewal period or lose coverage.
STEP 1: Update or Verify Your Info With KanCare
KanCare will use the information they have on file to decide if you and/or your family member(s) still qualify for Medicaid or CHIP coverage. If KanCare needs more information from you to make a coverage decision, they’ll send you a renewal form in the mail.
If your address with KanCare is not up to date — you may not receive the review form in the mail and could lose Medicaid or CHIP coverage in 2023.
You can make sure the KanCare Clearinghouse has your most current contact information by visiting kancare.ks.gov and clicking the red chat bubble in the lower right of your screen or by calling 1-800-792-4884. The red chat bubble is an online virtual agent called “KIERA” who can easily assist you with updating your required information, such as your current household address and phone numbers.
Once you have updated or verified your information, be sure to look for your review letter in the mail.
NOTE: Your renewal period is based on when your Medicaid coverage began. Your renewal period is typically the month before your annual renewal is due. You can call your MCO (Medicaid insurance provider) to ask when your renewal month is.
- Aetna: 1-855-221-5656
- Sunflower: 1-877-644-4623
- United Healthcare: 1-877-542-9235
The timeline for Unwinding is a 12-month window between April 2023 and March 2024. Annual renewals will continue for as long as the household has coverage. Reviews for Medicaid renewal are by household, not by the individual.
STEP 2: Fill Out, Sign & Return Your Renewal Form
Once you receive your KanCare review form in the mail it is extremely important that you fill it out, sign it, and return it to KanCare as soon as possible. Make sure you sign your review form — an unsigned form could result in you losing Medicaid or CHIP coverage.
NOTE: You have approximately 30 days to submit your review form back to KanCare.
If you do not submit your review form to KanCare within your review period (your due date will be on your review form), you may lose Medicaid coverage. KanCare will then contact your MCO to inform them you did not return your review form which may result in you losing Medicaid or CHIP coverage.
It is better to submit an incomplete review form to KanCare than to not submit your form on time.
Missing Your Renewal Form Could Result in a Loss of Coverage
What To Do If You Missed Your Renewal Form
Once KanCare mails your Medicaid renewal review form, you need to submit your review form back to KanCare within your review period. If you do not submit your review form within your review period, KanCare will contact your MCO to inform them you did not return your review form.
Your MCO will likely attempt to contact you if you fail to return your review form to KanCare on time. You may automatically lose coverage at this time (“disenrolled”). However, you have 90 days after you have been disenrolled to return your completed review form to KanCare.
If you return the completed review form during the 90-day window and are still eligible for Medicaid coverage, your enrollment could be backdated so you have continuous coverage. It is important to call your Medicaid provider (MCO) to ask for more information and work directly with them.
- Aetna: 1-855-221-5656
- Sunflower: 1-877-644-4623
- United Healthcare: 1-877-542-9235
Lost Medicaid Eligibility, Reapplying For Medicaid, & Other Healthcare Options
What To Do If You Lose Medicaid Coverage
If you are no longer eligible for Medicaid, KanCare will send you a letter in the mail telling you when your coverage will end. If you lost Medicaid or CHIP coverage for any reason, there are options available to help you get coverage at a price you can afford.
You may be able to reapply for Medicaid or CHIP
In many instances, your existing Medicaid or CHIP application can be reopened so you can reapply for coverage.
Call the KanCare Clearinghouse at 1-800-792-4884 to ask if your existing application can be reopened.
You may qualify for a Special Enrollment Period
If you or a member of your household lost qualifying health insurance in the past 60 days, or expect to lose coverage in the next 60 days, this may qualify you for a Special Enrollment Period with the Federal Marketplace.
HealthCore Clinic has Certified Health Navigators that can help!
Navigators are trained, unbiased individuals that can help you compare health insurance plans, assist you with the online application process, and provide answers to your Marketplace questions year-round. Services from our Health Navigators are completely free.
Medicaid & CHIP Renewal FAQs
FAQs
- What is unwinding?For the past three years, federal law has required states to keep Medicaid members on the rolls because of the COVID-19 public health emergency. During that time, Kansas Medicaid (KanCare) did not send out renewals as usual and instead kept members on the rolls without asking them to complete renewal paperwork. Recent changes in federal law mean the state must restart the usual renewal process. This process is referred to as “Unwinding.”
- What is a passive eligibility review?In a passive Medicaid review, KDHE electronically matches all required elements (such as income) against data sources and sends the household a letter telling them what information was used to review eligibility for another year. The household only needs to respond if the information used is not correct.
- What is a pre-populated review?In a pre-populated Medicaid review, KDHE is not able to electronically match all required elements (such as income) against data sources. The system pre-populates the review form with the information that KDHE does know and sends it to the family in the mail to complete the form and return it for processing.
- What determines if I receive a pre-populated or passive review?All Medicaid reviews start as a passive review. KanCare’s electronic verification system checks to see if required elements (such as income) have been completed. If KanCare does not have current information from the household or individual in the system, then the review cannot be completed via the passive process and becomes a pre-populated review. Required information can be updated or verified in advance of your renewal period by using the KIERA virtual assistant on the KanCare website.
- What can I do to prepare for Unwinding?Make sure your contact information is updated with KanCare. Contact information can be updated by clicking the red chat bubble in the lower right corner of the KanCare homepage. You can also call the Clearinghouse at 1-800-792-4884. Always read and respond quickly to any mail received from KanCare.
- I haven’t gotten a renewal yet. When will it be here?Not every KanCare enrollee will receive a renewal. Renewal forms will be sent in the mail over the course of a year in chronological order. If KanCare has your most current contact information, you will receive a renewal in the mail if you need one at the appropriate time.
- I’m worried I won’t get my renewal letter. What should I do?The most important thing any KanCare enrollee can do is make sure their contact information is updated. If you have updated your contact information, that is the most important thing you need to do. Your renewal form, if you need one, will be mailed to you in time for your renewal. If you have questions, call your MCO (Medicaid insurance provider) to ask when your renewal month is.
- Do I have to complete a renewal?Yes, even if none of your information has changed you must complete an annual renewal. KanCare is federally required to complete financial reviews once a year by the Centers for Medicare and Medicaid Services (CMS).
- I’ve been discontinued, but I have information that I think would make me eligible.If you have more information to report after you turn in your renewal form, contact the KanCare Clearinghouse at 1-800-792-4884. You can also reapply for KanCare at any time.
- I think I’ve been discontinued by error. What should I do?If you think there may be a mistake in your eligibility status, contact the KanCare Clearinghouse at 1-800-792-4884. If you still need help after you’ve contacted the Clearinghouse, you can contact the KanCare Ombudsman’s Office at 1-855-643-8180. If you would like to request an eligibility state fair hearing, you have the right to do so.
- What if I’m found ineligible for KanCare?If you’re not eligible for KanCare, you can check if you’re eligible for affordable health coverage at the Federal Marketplace. Many people find insurance plans for as low as $10 a month. Health Navigators are trained, unbiased individuals that can help you compare health insurance plans, assist you with the online application process, and provide answers to your Marketplace questions year-round — free of cost!
- What is the Health Insurance Marketplace?The Health Insurance Marketplace® is a service run by the federal government that helps people, families, and small businesses compare health insurance plans for coverage and affordability, enroll in or change a health insurance plan, find out about tax credits for private insurance or health programs like Medicaid or the Children’s Health Insurance Program (CHIP), and get answers to questions about health care insurance. The Marketplace is available online at: HealthCare.gov.
- What is a qualifying life event for Marketplace enrollment?There are many events that trigger a Special Enrollment Period opportunity such as loss of coverage, marriage, gaining a dependant, moving to another state, or specific changes in immigration status. You can learn more about qualifying life events and see if you qualify for coverage aquí.
Much of this article is a repost of valuable information from Cover Kansas, the statewide network of Health Navigators in Kansas. To read the original article, please click here.