What is the continuous coverage requirement for Medical Assistance (MA) and the Children's Health Insurance Program (CHIP), and why is it ending?

Because of the pandemic, the federal government allowed Pennsylvania and other states to continue Medicaid (also known as Medical Assistance or MA) and Children's Health Insurance Program (CHIP) coverage for most people even if they were not eligible anymore.

This policy is ending on March 31, 2023. After April 1, 2023, if you do not complete your renewal when it is due, you risk losing your health coverage.

Renewals are required due to the end of COVID-19 pandemic flexibilities. Maintaining healthcare coverage helps prevent the spread of COVID-19 and other diseases.

Starting April 1, 2023, if you get your health insurance from the state, you will need to complete your renewal every year when it is due to make sure you are still eligible to receive Medicaid or CHIP.

Everyone with MA or CHIP coverage will need to submit a renewal to see if they are still eligible.

Renewals will take place over 12 months, No one will lose their health coverage without having a chance to complete a renewal or update their information. But, if you do not return your renewal when it is due, you may risk losing your coverage.

I currently have Medical Assistance or CHIP coverage. What do I need to do now?

The best thing you can do now is make sure your phone number, email, and mailing address are up to date with the Pennsylvania Department of Human Services (DHS). Making sure your contact information is up-to-date means DHS can send you important information about your renewal in a timely manner. You can update your information through the COMPASS website and sign up for text or email alerts to get information faster when it is your time to renew. If you cannot access COMPASS, you can update your contact information by calling the Customer Service Center at 877.395.8930 or 1.215.560.7226 in Philadelphia.

Watch for mail, emails, and texts from DHS. Messages from DHS are sent to tell you about important actions you need to maintain your benefits or to let you know about programs that could be of assistance to you and your loved ones.

What do I need to do when the continuous coverage ends?

Your coverage will not automatically end on April 1. Your renewal date is unique to you and will happen sometime between April 1, 2023 and March 31, 2024. You will get a renewal packet in the mail when it is time to renew your MA or CHIP coverage. You will start to receive information in the mail about your renewal 90 days before it is due.

It is very important that you complete and return the renewal forms. Please complete your renewal if you know your circumstances have changed OR if nothing has changed. By completing your renewal, DHS can keep your MA or CHIP coverage open or connect you to other affordable health coverage options if you no longer qualify. There are four ways you can complete and submit your renewal:

• By mail — Complete and return the forms by mailing them back in the provided envelope.
• Online — Complete your renewal online in COMPASS.
• Telephone — Call 877.395.8930 to talk to a customer service representative.
• In person — Complete and submit your renewal in person at any local county assistance office (CAO). You can find your County Assistance office's contact information online.

Completing your renewal will help DHS determine if you are still eligible for MA or CHIP. If you are still eligible, your MA or CHIP coverage will continue.

When will I get my renewal packet?

Everyone's renewal date is different. You will start to get information about your renewal about 90 days before your renewal is due.

You can also complete your renewal online via COMPASS up to 60 days before your renewal date.

If you are not sure when your renewal date is due and you have a MyCOMPASS Account, you can find your renewal date in your MyCOMPASS Account with your benefit information. Signing up for a MyCOMPASS account is free and easy. Visit COMPASS, select 'Register', and create an account using your personal information.

How long do I have to complete and return my renewal?

There will be a due date listed on your renewal packet. If you need help completing your renewal or getting the needed verification documents by the due date, please contact your local County Assistance Office or the Statewide Customer Service Center at 877.395.8930.

If you do not complete your renewal by the due date, your state health coverage will end.

You can still submit your renewal up to 90 days after the date your Medicaid or CHIP coverage ends. You will receive a letter reminding you about completing your renewal during this 90-day period. If you are still eligible, your coverage will reopen with no gap in coverage.

What if I complete and return my renewal forms and am found not eligible for Medical Assistance or CHIP?

If you are no longer eligible for MA or CHIP, you will get a letter in the mail from DHS telling you that your MA or CHIP coverage is ending. You can appeal the decision if you believe it is not correct. Appeal and fair hearing rights and instructions for how to ask for an appeal will be in the letter from DHS.

If you are not eligible for MA or CHIP, DHS will send your information automatically and securely to Pennie^®, Pennsylvania's official health and dental insurance marketplace. You will get a letter if they share your information with Pennie^®. Pennie^® lets you shop for plans available in your area and is the only place to get financial assistance to help pay for coverage and/or out-of-pocket costs.

How can I find out if I qualify for financial assistance through Pennie^®?

Your family size and annual income will be used to determine if you are eligible to receive financial assistance that could help lower your monthly payment and/or out-of-pocket expenses. Depending on your circumstances, it is possible to qualify for both an advanced premium tax credit (APTC) and cost-sharing reductions (CSR). See if you qualify by visiting our subsidy calculator tool here.