Glossary/Terms to Know:

  • Medical Assistance (MA) in Pennsylvania includes Medicaid, which is a federal program that provides eligible individuals with health services such as medical, vision, and dental care health coverage.
    Note: There are also other state-funded programs that provide health services. Those programs were not impacted by the Public Health Emergency.
  • CHIP: Pennsylvania’s  Children’s Health Insurance Program (CHIP)provides health coverage to children and teens (age 18 and under) who do not have health insurance and are not eligible for or already getting MA. CHIP offers high quality, affordable coverage on three tiers based on family income: full cost, low cost, and free.  CHIP provides eligible children with health services such as medical, dental, vision, and behavioral health.

Medicaid & CHIP Renewals

Prior to the pandemic, states were required to renew coverage for people with Medicaid or CHIP coverage at least once a year and to disenroll individuals who no longer qualified for coverage. During the COVID-19 pandemic, Congress acted to ensure Americans did not lose access to critical health care by preventing states from terminating a person’s Medicaid coverage, even if they no longer qualified.

Now that the public health emergency has ended, federal law requires states to restart regular Medicaid renewals. This means that over the next 12 months, everyone with health care coverage through Medicaid or CHIP will renew their coverage. If an individual is no longer eligible for Medicaid or CHIP, they can transition to another form of health coverage, such as the Affordable Care Act Marketplace or employer-sponsored coverage.

In a normal year, about 17 million people lose Medicaid or CHIP coverage – some because they’re no longer eligible, but others because of red tape. That means that during the pandemic, more than 50 million Medicaid terminations did not happen.

To combat a possible flood of Medicaid terminations, The U.S. Department of Health and Human Services launched an all-hands-on-deck effort to work with external partners such as the National Urban League and its local affiliates like ours.

For people with Medicaid and CHIP coverage:

  • UPDATE your contact information with your state Medicaid or CHIP agency
  • RESPOND to the Medicaid/CHIP renewal form when it arrives in the mail to keep your coverage.
    • PA DHS will mail you a letter about your Medicaid or CHIP coverage (you can also renew online using their COMPASS system). This letter will also let you know if you need to complete a renewal form to see if you still qualify for Medicaid or CHIP. If you get a renewal form, fill it out and return it to your state right away. This may help you avoid a gap in your coverage.
  • PARENTS should respond even if you don’t think you’re eligible – your kids could still be eligible!
  • CONSIDER OTHER COVERAGE OPTIONS: If you are no longer eligible for Medicaid or CHIP, check if you can get coverage through your employer, through the Affordable Care Act Marketplace at gov, or through Medicare

You can also contact the DHS Statewide Customer Service Center, which will allow you to check or update your information over the phone. Call 1-877-395-8930 if you live outside Philadelphia, and 215-560-7226 if you are in Philadelphia.