Updated 4/13/2022

Reader Question: If unemployment payments make me no longer income-eligible, am I meant to go off Medicaid? And if I stay on Medicaid, will I have to pay for it?

Here is how we understand the rules:

Medicaid is funded by both federal and state governments. Here are the rules based on the federal guidelines linked below.

If you had Medicaid at any point on or after March 18th, you won’t be thrown off Medicaid until the end of the month when the “Public Health Emergency” expires. So, even if you are now no longer income-eligible for Medicaid (either you are earning more or your unemployment payments make you no longer income-eligible), then:

1. You still keep Medicaid until the end of the month when the public health emergency is over (the public health emergency declaration is currently set to expire on October 15, 2022, but is likely to be extended)
2. There shouldn’t be any penalty for having Medicaid now during Covid-19 even if you are currently not income-eligible.

What is this Public Health Emergency?
Due to Covid-19, a Public Health Emergency was declared on January 31, 2020, backdated to January 27. The public health emergency declaration lasts for 90 days. so it expired on April 26. The public health emergency was then extended for an additional 90 days, followed by a few more extensions. It is now set to expire on July 15, 2022.

DON’T HAVE MEDICAID AND WANT TO APPLY?

If you don’t have Medicaid (and didn’t have at any time on or after March 18, 2020) you need to be currently income-eligible to qualify.

Does Covid-19 financial assistance count as income towards Medicaid?
Here are how I understand the rules for NY. Check the rules for your state.

• PPP: Questionable.
• Unemployment
  • Regular and Pandemic unemployment (excluding the extra $600): Yes.
  • Extra $600 (PFUC) weekly bonus: No
• Rent Relief – NY State: No
• Stimulus Payment: No
• EIDL grant or loan: No

FURTHER READING

Are states required to provide continuous coverage for all Medicaid beneficiaries through the end of the month in which the emergency period ends?
Yes. In order to receive the temporary FMAP increase provided under section 6008 of the FFRCA, states must provide continuous coverage, through the end of the month in which the emergency period ends, to all Medicaid beneficiaries who were enrolled in Medicaid on or after March 18, 2020, regardless of any changes in circumstances or redeterminations at scheduled renewals that otherwise would result in termination. States may terminate coverage for individuals who request a voluntary termination of eligibility, or who are no longer considered to be residents of the state.
https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf

For the medically needy individual whose eligibility is maintained past his or her budget period solely on the basis of section 6008(b)(3) of the FFCRA, can the state, after the end of the emergency period, seek to recoup payments made from the individual?
No. A medically needy individual, or any other individual, whose Medicaid eligibility is maintained in order to comply with the conditions under section 6008(b) of the FFCRA to claim the temporary FMAP increase may not have his or her eligibility retroactively terminated or assistance retroactively reduced. In order to receive the temporary FMAP increase authorized under section 6008 of the FFCRA, states must maintain the eligibility, and benefits, of all individuals who are enrolled or determined eligible for Medicaid as of March 18, 2020, through the end of the month in which the public health emergency ends. Section 6008(b) of the FFCRA does not authorize recoupment of funds from any individual whose Medicaid eligibility was continued in order to comply with the terms or section 6008(b) of the FFCRA.
https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf (page 29)

Could I lose my Medicaid coverage if I forget to renew it during the COVID-19 emergency?
No. Everyone with Medicaid coverage on or after March 18, 2020 will keep their coverage unless they cancel it or move out of New York State during the COVID emergency. You do not need to take any action to keep your coverage.
If your case was closed and you had coverage on or after March 18, 2020, your coverage should now be reinstated. If your case is closed, call the NYS Medicaid Helpline at 1-800-541-2831 for help.
https://www.health.ny.gov/health_care/medicaid/covid19/factsheets/docs/eng_guide_med_cons_enrolled_thru_ldss.pdf

[Disclaimer: As with everything on this site, I am not giving legal or financial advice. You are responsible to do your own due diligence.]

LINKS

• A clearly written explanation from EmpireJustice.org
• Press Release regarding declaration of Public Health Emergency