All Medicaid Programs |
Obsolete Policy |
Effective Date: January 1, 2020 - November 30, 2021
No Previous Policy
An individual who fails to meet the ESI enrollment requirements may lose eligibility for Adult Expansion Medicaid and will no longer receive an ESI premium reimbursement.
The ineligibility period is 12 months and begins the month following the closure of Adult Expansion.
The following are reasons an individual will lose Adult Expansion Medicaid coverage and the ESI premium reimbursement. The individual was required to participate and:
Voluntarily terminated their qualified employer-sponsored health plan coverage; or
Voluntarily changed from a qualified employer-sponsored health plan to a non-qualified employer-sponsored health plan; or
Refused to enroll in their qualified employer-sponsored health plan within 30 days or failed to verify their enrollment
The ineligibility period will not apply to the following individuals, and they will remain eligible for Adult Expansion Medicaid:
Verified American Indians/Alaskan Natives
Individuals who are not required to participate, but choose to do so.
Individuals who no longer have access to a qualified employer-sponsored health plan. These individuals can reapply and show they no longer have access.
Individuals who have been terminated from a job, or have quit a job, and lose health insurance coverage as a result. These individuals can reapply and show they no longer have access to employer-sponsored insurance.