Individuals losing eligibility for MaineCare can enroll in plans on CoverME.gov through July 31, 2024
AUGUSTA— The Maine Department of Health and Human Services (DHHS) announced today the launch of a Special Enrollment Period (SEP) through CoverME.gov, Maine’s Health Insurance Marketplace, to help Maine people transitioning from MaineCare coverage after the COVID-19 pandemic explore affordable health insurance options and avoid gaps in coverage. The Special Enrollment Period began on April 15, 2023, and will continue through July 31, 2024, allowing Maine individuals found no longer eligible for MaineCare to apply for plans through CoverME.gov outside of the annual Open Enrollment Period.
This Special Enrollment Period coincides with the yearlong process for MaineCare to redetermine eligibility for current members as required by federal law. During the COVID-19 emergency, MaineCare, along with all other states’ Medicaid programs, maintained continuous coverage by suspending eligibility redeterminations for its members. That suspension has ended. The DHHS Office of the Health Insurance Marketplace, which runs CoverME.gov, added the Special Enrollment Period to ensure that MaineCare members who are no longer eligible for that program have time to explore private plans and financial assistance to help them afford private coverage.
“This Special Enrollment Period will help those transitioning from MaineCare find a plan that works for them and maintain critical health coverage,” said DHHS Commissioner Jeanne Lambrew. “We encourage anyone concerned about losing MaineCare coverage to visit CoverME.gov to explore their options and stay covered.”
National estimates for Maine indicate that 90 percent of those who are determined no longer eligible for MaineCare will be able to receive coverage through other sources including CoverME.gov. This new Special Enrollment Period is the same as that being used in all 33 states using HealthCare.gov as well as other State-based Marketplaces.
In March 2020, the federal government temporarily suspended Medicaid requirements to redetermine eligibility in order to prevent people from losing their health coverage during the pandemic, even if their circumstances changed during that period. This is known as the “continuous coverage requirement.” People who would otherwise lose eligibility due to increased earnings, change of family status, or other reasons have remained covered by Medicaid for needed care during the pandemic.
Until recently, the end date for the continuous coverage requirement was tied to the end of the federal Public Health Emergency (PHE). In December 2022, Congress passed the Consolidated Appropriations Act, which separated the continuous coverage requirement from the COVID-19 PHE and set a fixed end date of March 31, 2023. With the end of the continuous coverage requirement, the DHHS Office for Family Independence (OFI) will review eligibility of everyone enrolled in MaineCare over the next year and disenroll individuals no longer eligible. OFI initiated redeterminations this month and will complete them by the summer of 2024.
Individuals found ineligible for MaineCare during their renewal process because of income or other reasons will have their information transferred automatically to CoverME.gov. People losing MaineCare coverage should visit CoverME.gov to create or log into an account, submit or review their application, and select “Recently lost MaineCare” from the list of Special Enrollment Periods. When they complete the application, CoverME.gov will determine if they are eligible for financial assistance to lower their CoverME.gov premium or out-of-pocket costs.
Consumers do not have to wait for their MaineCare coverage to end before they apply on CoverME.gov and should report that loss of coverage as soon as possible to avoid a gap in coverage. An FAQ about the Special Enrollment Period is available on CoverME.gov.
The Special Enrollment Period is part of DHHS’ efforts to make MaineCare members aware of the upcoming changes and support them through the redetermination process. Last month, DHHS launched a “Stay Connected to Stay Covered” outreach campaign, urging MaineCare members to update their contact information so the Department can reach them about renewing their coverage and to be on the lookout for their renewal form, which must be filled out and returned to avoid a gap in coverage. The campaign includes multilingual communications and outreach materials for partners to download and a paid advertising campaign, which includes radio advertising, a social media campaign, and digital advertising. More information about the redetermination process, and other important information for MaineCare members and stakeholders, is available at mainecare.gov/unwinding.
People who are currently enrolled in MaineCare should make sure their contact information is up to date by visiting MyMaineConnection.gov or calling 1-855-797-4357. When it’s time for renewal, they should look out for an envelope with a blue block, which will have renewal information and instructions inside. If it's blue, it's time to renew! Members who signed up for e-notices should keep an eye on their email for a message when it is time for their renewal.