Unwinding Continuous Medicaid Eligibility

Continuous Eligibility Background

At the beginning of the COVID-19 pandemic, the federal government declared a public health emergency or PHE. During the PHE, state Medicaid agencies have been required to continue Medicaid coverage for all members, even if their eligibility changes. As a result, Utah Medicaid members have stayed covered during the PHE so they don't have to worry about their health coverage during this challenging time.

On December 23, 2022, Congress passed the FY 2023 Consolidated Appropriations Act.  One part of this bill separated the federal PHE and Medicaid’s continuous enrollment policy. This Act establishes April 1, 2023, as the end of the continuous enrollment requirement for Medicaid. The federal PHE will end on May 11, 2023, which will also end the COVID-19 Uninsured Coverage Medicaid program.

Unwinding Medicaid Eligibility

On March 1, 2023 the Department of Workforce Services (DWS) will begin to review all Medicaid cases over the next 12-month unwinding period.  This is being referred to as “unwinding.”  Members will be assigned a review month and their case will stay open until their scheduled review month.  Members are encouraged to continue using their benefits as normal until DWS completes their review.

To monitor this process over the course of those 12 months, DWS will provide transparent tracking data which will be available  and updated on the Continuous Eligibility Unwinding Dashboard.  

Call to Action

Many people moved during the pandemic.  It is critical that the state is able to reach members when it is time to review their eligibility.  Utah Medicaid is asking members to:

• • Keep their contact information current

If a member moved during the pandemic or if any of their contact information like their phone number or email address has changed, please call their health plan, DWS (1-866-435-7414 or  jobs.utah.gov/mycase), or an HPR (1-866-608-9422) to update this information.

• • Watch for DWS letters

Members should pay close attention to their mail and/or email for notices and respond timely to reviews. After February 11, members can check myCase to see their review date.

• • Complete review

All medical programs are renewed each year.  In a member’s assigned review month, DWS will try to complete the review without member involvement and send the member a notice saying their review is complete.  If DWS does not have enough information, the member will be asked to complete their review. 

For additional information for members, please read this helpful FAQ.  Since DWS eligibility will need to review all Medicaid cases in the next year, we are asking members to wait until they receive their review before taking action.  During this time callers may experience longer call wait times to speak to a DWS eligibility worker.