Medicaid Continous Coverage Protections End

As reported in several recent newsletter articles, the Medicaid (Medical Assistance) continuous coverage protections tied to the pandemic ended on March 31, 2023.  Between March 2020 and March 2023, most individuals on Medicaid could not be terminated from coverage even if they were no longer eligible and even if they failed to complete and return their annual renewal paperwork.  Now that these continous coverage protections are over, Medicaid recipients who are no longer eligible and those who do not complete and return their renewal packet with required documentation will have their Medicaid benefits stopped.

However, no one should be terminated from Medicaid without first having the chance to renew their benefits.  Within 90 days prior to someone's renewal date, and again at 60 days prior to the renewal date, written communication will be mailed from the Department of Human Services (DHS) notifying the Medicaid recipient of their upcoming renewal date.  Within 30 days of the renewal date, a renewal packet will be mailed with a specified due date.  Individuals who have moved or changed phone numbers within the past 3 years and who have not notified the County Assistance Office (CAO) of the change should do so immediately to ensure their renewal packet is mailed to their current address.  To update contact information and other details, Medicaid recipients can call the Statewide Customer Service Center at 1-877-395-8930 (in Philadelphia call 215-560-7226). 

When submitting a Medicaid renewal, the CAO will ask for updated proof of income and/or resources. If the CAO does not receive the documents in time, or if the renewal packet is not submitted, a notice will be sent stopping Medicaid benefits because the CAO did not receive the required information. If this happens, Medicaid recipients should appeal immediately.  Additionally, they should ask for Reconsideration and submit the renewal and/or documentation as soon as possible”. If the missing renewal or verification documents are submitted with in 90 days, the CAO will “reconsider” the person’s eligibility instead of having the person complete a whole new application. A Reconsideration is one way to resolve an appeal once it is filed, without the need to go to a fair hearing. Our new Reconsideration Toolkit outlines the steps to ask for Reconsideration when Medicaid benefits are stopped.

Those needing assistance with Medicaid eligibility or appealing a Medicaid termination or denial can contact their local Legal Aid office or PHLP's Helpline at 1-800-274-3258.