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  • Writer's pictureViktoriya Fine

Important Update about Medicaid Redetermination

Updated: Mar 13

Medicaid redetermination has not been in effect since March 2020. NJ FamilyCare/Medicaid has followed special rules related to the federal COVID-19 Public Health Emergency (PHE) which allowed most NJ FamilyCare/Medicaid members to keep their health coverage, even if they no longer qualified. This means that families with higher incomes qualified for Medicaid coverage. Congress recently passed legislation that said state Medicaid programs have to go back to following normal federal rules on April 1, 2023.

NJ FamilyCare is going to start re-determining members’ eligibility on April 1, 2023. This means that all members enrolled in an NJ FamilyCare program will be reviewed to see if they still qualify for coverage. As part of this review, many members will receive mail from the State of New Jersey or their County Board of Social Services. Members will have to provide or confirm additional information so NJ FamilyCare/Medicaid can decide whether they still qualify for healthcare coverage. Members who do not respond to NJ FamilyCare/Medicaid mail may lose their coverage.

Here’s the botomline:

  • Beginning as early as April 1, about 15-18M people no longer will be eligible for Medicaid

  • While April 1st is the earliest date on which people may be disenrolled from Medicaid, it’s expected that states will initiate their redetermination process throughout 2023..

Coverage options:

If you no longer qualify for Medicaid and your enrollment is being terminated, there are ways to stay covered. Losing Medicaid coverage is called a qualifying life event because it may impact your health insurance. Experiencing a qualifying life event means you can enroll in a new health plan right away as part of a special enrollment period.

Most people have 3 options:

1. A health plan through your work

2. A health plan offered through the Health Insurance Marketplace

3. Medicare, if you are 65 or older

At Adult Family Health Services, you can apply for NJ FamilyCare and other available state funding (depending on the service and income eligibility). Please contact Adult Family Health Services at 973.773.7600 for an intake appointment and we will present all available options to you.

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