On April 1, 2023, Oregon and Washington began the annual Medicaid redetermination process for each Medicaid enrollee to ensure that they are still eligible for Medicaid benefits. During this process, some enrollees will lose eligibility and as a result, lose their Medicaid coverage.

Individuals who lose Medicaid coverage:

• Prior to July 10, 2023 will have until September 8, 2023 to enroll in another plan.
• On or after July 10, 2023 will have 60 days to enroll in another plan.
  

Coverage options

For those individuals who no longer qualify for Medicaid, they still have choices for quality, affordable coverage. Coverage options may include:

• Employer-sponsored health plans
  
  • Once Medicaid coverage terminates, if employer coverage is an option, the individual will have 60 days to enroll in alternate coverage.
• Individual ACA plans through the Federal Marketplace (Oregon), Washington Healthplanfinder or directly through carriers, like Kaiser Permanente
  • Financial assistance could be available to those enrolling through the marketplaces, depending on their income. In 2023, it is estimated that 90% of marketplace consumers will receive financial assistance through Advanced Premium Tax Credits (APTC), and on average, these consumers saved over $800 in premiums per year.¹
  • All of Kaiser Permanente’s Individual and Family plans cover things like prescription drugs, doctor visits, urgent care, hospital visits, and more.
  • Kaiser Permanente Medicaid members who transition to another Kaiser Permanente plan can continue seeing their Kaiser Permanente doctors, for a seamless care experience regardless of their coverage type.
• Medicare for people 65 and over

How you can help during the redetermination process

Brokers play an important role in helping consumers and your group clients navigate the complex world of health care coverage every day. Medicaid enrollees losing their Medicaid coverage will need help understanding their options to stay covered and finding the right plan for their unique needs.

During this transitional period for consumers, you can earn an additional bonus for new Kaiser Permanente for Individual and Family (KPIF) plan sales.

Resources you can use

Use the tools below to share information about coverage options with individuals and your group clients with employees who have lost Medicaid coverage:

• Employee/individual flyer - How to stay covered if you lose your Medicaid coverage
  
• 2024 Individual and family plan comparison flyer (Oregon)
• 2024 Individual and family plan comparison flyer (Washington)
• Medicaid Redetermination Digital Toolkit
  
  • Instructions
    
    
  • Flyer
    English (PDF) | Amharic (PDF) | Chinese (PDF) | Korean (PDF) | Russian (PDF) | Spanish (PDF) | Vietnamese (PDF)
    
    
  • Poster
    English (PDF) | Amharic (PDF) | Chinese (PDF) | Korean (PDF) | Russian (PDF) | Spanish (PDF) | Vietnamese (PDF)
    
    
  • Postcard
    English (PDF) | Amharic (PDF) | Chinese (PDF) | Korean (PDF) | Russian (PDF) | Spanish (PDF) | Vietnamese (PDF)
    
    
  • Social media post
    English (PDF) | Spanish (PDF)
    
• Medicaid Renewal Guide for individuals
• How to keep your Kaiser Permanente coverage webinar
• Kaiser Permanente’s continuation of coverage website
• Medicaid redetermination process explanation video

¹CMS Press Release, 3/23/2023: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-celebrates-affordable-care-acts-13th-anniversary-and-highlights-record