December 12, 2024
Maine's Medicaid program (MaineCare) successfully concluded a process known as the "unwinding" of the continuous Medicaid eligibility requirement. Following the end of the COVID-19 Public Health Emergency in 2023, updates to federal rules meant that every MaineCare member needed to have their coverage reviewed to ensure they could remain eligible. This process began in May 2023, and eligibility redeterminations were completed by October 31, 2024, with nearly 80% of Maine people successfully renewing their MaineCare coverage.
Ensuring eligible Mainers stay covered on MaineCare, or through CoverME.gov for those who no longer meet MaineCare eligibility requirements, is a top priority across the Department of Health and Human Services (DHHS).
The unwinding effort was carefully planned around four foundational pieces to ensure a thorough and efficient process as eligibility redeterminations for over 400,000 individuals were completed.
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The plan included a robust communication and outreach strategy to ensure public awareness of the unwinding effort and clear renewal instructions for Maine people to follow.
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The Department engaged with community-based organizations across the state to educate and assist MaineCare members with renewals, or with transitions of coverage to plans on CoverME.gov.
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The Department utilized passive renewal technology, which increased processing efficiency. Passive renewal allows for MaineCare benefits to be renewed for individuals without a reapplication process if their eligibility requirements continue to be met. This process includes verifying continued eligibility through electronic tools and data already available to the department.
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A temporary staffing partnership provided critical call center and processing assistance in addressing the increased work volume.
Operating on these foundational components, along with strong intradepartmental collaboration between the Offices of MaineCare Services (OMS), Family Independence (OFI), and the Health Insurance Marketplace (OHIM), Maine's unwinding retention rates were among the best in the country.
While the unwinding process has concluded, there are a few important reminders to ensure efficient and uninterrupted MaineCare coverage going forward, as the State returns to OFI's standard renewal process. Going forward MaineCare members should:
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Report address, telephone, and email changes as soon as they occur. Members can visit MyMaineConnection.gov or call 1-855-797-4357 and press option 1 to update contact information through an automated system.
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Complete and return renewal forms to the Department by the deadline either by mail or online at MyMaineConnection.gov
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Members who do not return a completed renewal form will have their MaineCare coverage closed. There is a 90-day reconsideration period where members can submit their paperwork at MyMaineConnection.gov, or call the Office for Family Independence call center at (855) 797-4357 for assistance, to avoid a gap in their health care coverage.