2023 Federal Health Emergency

Medicaid beneficiaries may be required to reenroll as Medicaid redetermination resumes in April 2023

SummaCare Individual and Family plans are more affordable than you think!

The COVID-19 Public Health Emergency & Medicaid Eligibility

In direct response to the COVID-19 pandemic, a Public Health Emergency (PHE) was enacted on January 27, 2020. During the PHE, yearly state Medicaid eligibility reviews due to unemployment and an urgent need for health coverage were paused thanks to Federal law. While the PHE was active, all Medicaid and CHIP members were able to keep their coverage—regardless of eligibility or status changes.

When Medicaid Returns to its Prepandemic Review Process—You May Lose Coverage

Prior to the pandemic, Medicaid eligibility was reviewed by each state on an annual basis. Changes in an individual’s income, age or other factors could cause a state to determine that individual was no longer Medicaid-eligible and would lead to disenrollment. 

The COVID-19 PHE placed the standard Medicaid renewals on hold allowing coverage for many beneficiaries to continue without a yearly review. When Medicaid redetermination resumes, some people may lose their Medicaid coverage.

Those individuals on Medicaid will need to complete a renewal review with their state to see if they are still Medicaid-eligible. For those who discover they no longer qualify for Medicaid, SummaCare can help you maintain coverage—through an Individual Marketplace plan, Medicare or through your employer.

Prepare for Your Renewal

In order to prepare for your renewal, make sure your address is updated with the Ohio Department of Medicaid.  

• Call the Ohio Medicaid Consumer Hotline: Calling will connect you with a representative who can update your contact information. Representatives are available Monday – Friday from 7:00 a.m. – 8:00 p.m. as well as Saturdays from 8:00 a.m. – 5:00 p.m. at 1.800.324.8680.
• Online Portal: If you have an Ohio Benefits Self-Service Portal account, you can login and report changes to your contact information.
• Contact your local JFS: The best and easiest option is to contact your County Department of Job and Family Services. A JFS caseworker can assist in updating your information. This is the quickest and easiest way to verify or change your contact information.

Taking action as soon as possible will reduce your risk of losing coverage during the redetermination process. 

Finding Affordable Health Coverage If I’m No Longer Medicaid-Eligible

SummaCare can help connect you to a plan that’s right for you. If you’re under age 65 and not eligible for health insurance through your employer, a Marketplace plan for Individuals and Families may be right for you.

SummaCare Individual and Family plans are available to those living in Summit, Stark, Portage and Medina counties and include the SCConnect exclusive provider network featuring Summa Health’s Accountable Care Organization, NewHealth Collaborative. This network provides access to many of the area’s finest physicians, facilities and hospitals including Summa Health, Cleveland Clinic Mercy Hospital and Akron Children’s Hospital.

All Individual and Family plans provide comprehensive medical and pharmacy benefits, plus:

• Competitively-priced premiums
• Three FREE combined office visits on most plans to SummaCare Primary Care Providers* and outpatient mental health services for each person on the policy
• Access to telehealth visits through Teladoc™ Health for general medical, dermatology and behavioral health visits
• Low copays on specialist office visits and generic prescriptions on most plans
• Assist America^® global emergency healthcare services when traveling available on many plans
• Adult vision exam available on many plans
• Health and wellness programs and services