30-Day Marketplace Reminder Letters for Consumers Denied Medicaid/CHIP Coverage

Health Insurance Marketplace® sent this bulletin at 12/05/2022 12:33 PM EST

agents and brokers - selling in the healthcare dot gov marketplace

30-Day Reminder Letter

for Consumers Denied Medicaid/CHIP Coverage

The Centers for Medicare & Medicaid Services (CMS) wants to ensure that eligible consumers retain enrollment in Medicaid/Children's Health Insurance Program (CHIP) coverage, and that consumers who are ineligible for Medicaid/CHIP gain timely access to the most appropriate health coverage, including Marketplace coverage.

To improve strategies used to assist consumers who are ineligible for Medicaid/CHIP coverage in retaining health coverage once the Public Health Emergency (PHE) ends, the Marketplace is launching a consumer outreach pilot to supplement existing outreach efforts for consumers who are denied for Medicaid/CHIP.

When a consumer applies for Medicaid/CHIP and is denied for
non-procedural reasons, their State Medicaid/CHIP Agency (SMA) automatically sends their application to the Marketplace for eligibility consideration. The Marketplace then sends an initial notice to inform the consumer that they may be eligible for Marketplace coverage. During the Open Enrollment Period (OEP), if a consumer has not enrolled in
coverage within 30 days of their Medicaid/CHIP denial, they will receive an additional letter notifying them that they may be eligible for a Marketplace plan.

The 30-Day Reminder Letter templates are available to agents and brokers to view here, under “30-Day Marketplace Reminder Letters for Consumers Denied Medicaid/CHIP Coverage.” These letters inform consumers of enrollment assistance and resources, such as Find Local Help, so agents and brokers should make sure their information is up to date on these tools.

During the OEP, 30-Day Reminder Letters will be sent to consumers who:

Are not enrolled in Medicaid/CHIP but apply for this coverage through their SMA and are denied beginning early September.
Are present in the inbound account transfer (IB AT) from their state.
Are not yet enrolled in coverage after approximately 30 days of the Federally-facilitated Marketplace (FFM) receiving the IB AT.
Are in FFM states or in states with State-based Marketplaces operating on the Federal Platform (SBM-FP), including Arkansas, Oregon, and Virginia.

Have questions? For additional assistance, contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

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