Updates to Maine’s Unwinding Plan
Guest article contributed by Audra Stewart-Gordon, Community Health and Communications Coordinator
Since the unwinding process was initiated in April 2023, several policy updates from the federal Centers for Medicare and Medicaid Services (CMS) have impacted Maine’s unwinding plan and timeline.
“Passive” or “ex parte” renewal is a federal requirement that directs states to check sources showing earned income data to determine a member’s eligibility. If such data sources confirm eligibility, the state automatically renews Medicaid coverage without requiring manual completion or return of a renewal form. Maine implemented passive renewals at the household level in August 2023.
In August 2023, CMS issued guidance directing about half of states, including Maine, to halt “procedural disenrollment” until passive or “ex parte” renewal at the individual level is implemented.
This means that, until the individual-level passive renewal process is effective, a state cannot disenroll a member who has neither been renewed through the passive process nor returned their subsequent renewal form. Maine has continued to pause disenrollments for nonresponse until individual-level passive enrollment is implemented in July 2024.
In the fall of 2023, CMS clarified that states could extend the unwinding period. Maine has shifted the end of the issuance of unwinding redeterminations to October 31, 2024, to account for additional renewal processing work after the individual-level passive renewal system is in place in July 2024.
Ensuring Continuity of Coverage
The Department is committed to minimizing disruption in coverage. For those no longer eligible for MaineCare, there will be an application transfer to CoverME.gov, Maine's Health Insurance Marketplace. CoverME.gov is conducting targeted outreach and providing a special enrollment period for those losing MaineCare coverage from April 15, 2023, through December 31, 2024.
What You Should Do Now
If you receive healthcare coverage through MaineCare, you will be sent a renewal form by mail or e-notice (many Mainers have already received theirs). Over 300,000 Mainers have already renewed their coverage. To stay covered, it's crucial to take the following steps:
Update Your Address: If you've moved, inform MaineCare of your updated address so they can contact you about your renewal. Also, make sure they have your current email and phone number. You can update your information by calling 1-855-797-4357 (option 1) through an automated system, or by visiting MyMaineConnection.gov.
Stay Connected: Keeping your contact information up to date ensures you receive all necessary communications about your coverage and renewal process.
Look for Your Renewal Form: If you have not already received it, be on the lookout for an envelope with a blue block that contains renewal information and instructions. If you signed up for e-notices, you would get a message in your account when it's time for your renewal.
Complete and Return the Form: Fill out the renewal form as soon as you receive it and return it right away to avoid any gaps in your coverage. MaineCare reviews will be completed by October 31st. Remember, "If it’s blue, it’s time to renew!"
Upcoming Eligibility Changes
Starting November 1, 2024, additional changes to MaineCare eligibility and enrollment will be phased in. Here’s what to expect:
Resumption of Premiums: Premium payments will resume for certain coverage groups, including Katie Beckett, Special Benefits Waiver, and MaineCare for Working People with Disabilities after the household completes its annual renewal. Unpaid premiums could result in a loss of coverage.
Verification of Financial Factors: Verification of financial information will be required at application, renewal, or reported change if the Department cannot verify income through electronic data sources.
For more information or assistance, visit MyMaineConnection.gov or call (855) 797-4357.