During the COVID-19 pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA). The FFCRA included a requirement that Medicaid agencies keep people enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends. This is referred to as the Medicaid continuous coverage requirement and means that the vast majority of Medicaid and Children’s Health Insurance Program (CHIP) members’ benefits remained open to provide continuous coverage during the PHE. In Maine, Medicaid is referred to as MaineCare which includes Cub Care (CHIP).
In December 2022, Congress passed the Consolidated Appropriations Act of 2023, which included a provision separating the Medicaid continuous coverage requirement from the COVID-19 public health emergency by providing a fixed end date of March 31, 2023 for Medicaid continuous coverage. With the end of the continuous coverage requirement, states will need to review eligibility of everyone enrolled in Medicaid and disenroll individuals no longer eligible. The federal government is referring to this process as the “unwinding.” In Maine, the Office of Family Independence (OFI) will initiate redeterminations over 12 months starting in April, when they will issue May 2023 Renewals. If you’re currently enrolled in MaineCare, make sure your address and other information are up to date and keep an eye out for renewal notices from OFI. For more information, please visit mainecare.gov/unwinding.
CoverME.gov Launches Special Enrollment Period for Maine People Transitioning from MaineCare - 04/19/2023
Consumer Enrollment Guide (PDF)
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What temporary Special Enrollment Period is CoverME.gov offering?
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CoverME.gov is offering a Special Enrollment Period (SEP) for Marketplace-eligible consumers who are losing MaineCare due to the end of the continuous coverage requirement (unwinding). The name of the Special Enrollment Period is “Recently lost MaineCare.” CoverME.gov will be offering this self-service SEP from April 15, 2023, through July 31, 2024. During this time, Marketplace-eligible consumers who are losing MaineCare can access the Special Enrollment Period by creating or logging into their CoverME.gov account and selecting ‘Recently lost MaineCare’ from our list of Special Enrollment Periods.
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A consumer recently lost MaineCare, are they eligible to enroll on CoverME.gov?
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To determine if a consumer is eligible for Marketplace coverage, they must visit CoverME.gov and enter their information to create an account. If OFI transferred their information to CoverME.gov after their MaineCare coverage was terminated, they will be automatically matched to their existing application based on their first name, last name, date of birth, and social security number. When they complete the application, CoverME.gov will determine if they are eligible for financial assistance to lower the cost of their Marketplace premium or out of pocket costs. In the “Health Coverage” section of the application, they should make sure to indicate that they recently lost MaineCare coverage. After they finish the application, they can select the “Recently lost MaineCare” Special Enrollment Period (SEP) from the SEP menu. Once they have applied the Special Enrollment Period, they can shop for and enroll in a Marketplace plan.
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Do consumers need to wait until their MaineCare or Cub Care coverage ends before they can enroll on CoverME.gov?
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Consumers do not have to wait for their MaineCare coverage to end before they apply on CoverME.gov. Consumers should report that loss of coverage as soon as they know their MaineCare coverage will be ending. To avoid a gap in coverage, they should visit CoverME.gov as soon as possible once they know their MaineCare coverage will be ending.
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After a consumer enrolls on CoverME.gov, when will their coverage be effective?
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If consumers utilize the “Recently lost MaineCare” Special Enrollment Period (SEP), their coverage will take effect the first of the month following the date they select a plan. For example, if they enroll in a plan on June 20, 2023, that coverage will begin July 1, 2023. This Special Enrollment Period will not be available retroactively, so we encourage consumers to log in and select a plan as soon as possible.
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How long do consumers have to select a plan on CoverME.gov?
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Consumers who are eligible for the “Recently lost MaineCare” Special Enrollment Period (SEP) will have 60 days after they submit their application and report the Special Enrollment Period to select a Marketplace plan with coverage that starts the first day of the month after they select a plan.
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Is there a new application question that consumers must answer to be determined eligible for the temporary SEP?
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There is not a question on the application that consumers must answer to utilize the ”Recently lost MaineCare” Special Enrollment Period. However, CoverME.gov has made updates to the existing application question in the “Health Coverage” section of the application that asks about a recent loss of MaineCare coverage. Consumers will want to make sure that they answer that question so that CoverME.gov can accurately determine their eligibility for financial assistance.
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Will consumers need to provide documentation to verify their eligibility for the Unwinding SEP?
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Consumers will not be required to submit documentation of a qualifying life event to be eligible for the “Recently lost MaineCare” Special Enrollment Period on CoverME.gov. Consumers will be asked to report a loss of MaineCare coverage as part of the application.
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What if a consumer lost their MaineCare coverage, but doesn’t report it to CoverME.gov within 60 days?
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Anyone who loses MaineCare coverage between April 15, 2023, and July 31, 2024, can use the “Recently lost MaineCare” Special Enrollment Period to enroll in coverage prospectively on CoverME.gov. However, consumers should visit CoverME.gov to apply and enroll in coverage as soon as they’re found ineligible for MaineCare to avoid a gap in coverage since retroactive effective dates will not be permitted.
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What should consumers do if they aren’t sure whether their MaineCare or Cub Care coverage is ending?
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Consumers should log into the My Maine Connection portal at mymaineconnection.gov to make sure that their contact information is up-to-date, and to ensure that they are receiving all communications regarding their enrollment status. They should also keep an eye out for renewal notices from the Office for Family Independence. For more information on the redetermination process, you can visit mainecare.gov/unwinding.
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Will consumers be able to enroll on CoverME.gov after July 31, 2024?
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After July 31, 2024, consumers who were unable to enroll in Marketplace coverage on CoverME.gov because they did not receive a timely notice of termination of MaineCare coverage may contact the CoverME.gov Consumer Assistance Center at 1-866-636-0355 (TTY: 711) to request a Special Enrollment Period, which will be granted on a case-by-case basis.