KanCare Updates: Eligibility Redeterminations and CHIP Premium Payments
Heather Braum | April 13, 2023
Major changes to the state’s KanCare program are now underway. The restart of eligibility redeterminations and renewals for the first time since March 2020 puts kids at particular risk of losing their KanCare coverage if administrative paperwork is not turned in. And, Children’s Health Insurance Program (CHIP) premium payment policies started to be enforced again on April 1, 2023, meaning parents must again remain current on payments for their children to continue receiving coverage.
Eligibility Redeterminations Restarted
KanCare is the state’s managed care insurance program administering Medicaid and CHIP. KanCare provides health insurance to low-income children, pregnant women, and some caretakers of children; seniors; and people with disabilities across the state.
Unfortunately, eligible KanCare enrollees are at high risk of losing their coverage within the next year. KanCare enrollees have not had to renew their coverage or provide eligibility proof since March 2020. However, the end of the three-year continuous enrollment period for KanCare was March 31, 2023.
You may hear this referred to as the “unwinding,” “end of continuous eligibility,” the “public health emergency unwinding,” or the “restart of Medicaid redeterminations or renewals.” Those descriptors all mean the same thing: KanCare enrollees will have to go through the process of showing they are still eligible for the program, which typically happens annually but hasn’t been done since March 2020 due to provisions passed by Congress in the early days of the pandemic.
Last month, the state sent out the first batch of KanCare renewal notices for those KanCare enrollees whose renewal date is in April. These notices will continue to be sent out each month over the next year. As of April 1, the state has started and will continue reviewing returned renewal forms to determine ongoing eligibility.
For KanCare enrollees determined to be no longer eligible or who do not return the requested information, their KanCare coverage will be discontinued on May 1. (If someone still eligible is late in responding to the renewal notice, a three-month grace period kicks in on May 1, if renewal information is submitted during the three-month grace period). This review process will continue to cycle through each month over the next year, as the state returns to normal renewal review procedures and timelines. If someone is found ineligible for KanCare, they can connect with a Kansas Navigator to find possible coverage options.
Kansas kids with KanCare coverage are at a high-risk of losing their coverage
When kids have health coverage, they can go to the doctor and dentist, receive routine immunizations, receive medication, get treatments and therapies when needed, and go to the hospital. A lack of health care, especially in childhood, leads to life-long chronic conditions, shorter life expectancy, increased lifetime medical costs, and sicker families. Healthy kids are more likely to enter school ready to learn, graduate high school, and become healthy, productive adults.
More than 62 percent of KanCare enrollees are children – that’s why it’s critical that caregivers of these KanCare enrollees are reached about the changes ahead, as they will most likely be the ones to update contact information and fill out the renewal forms. Even more urgent, a recent report from the Georgetown Center for Children and Families (CCF) shows that almost 64 percent of the KanCare enrollment increase between February 2020 and August 2022 was from kids getting signed up for coverage. These kids’ caregivers may have never had to previously renew their kids’ coverage. These kids are at particularly high risk of losing coverage in the months ahead, even as many may remain eligible.
According to another analysis from Georgetown CCF, an August 2022 federal report estimated that nationally, about 72 percent of kids enrolled in Medicaid are at risk of losing their coverage, yet remain eligible. Research shows that when large numbers of eligibility redeterminations occur, “churn rates” (defined as “the temporary loss of Medicaid coverage in which enrollees disenroll and then re-enroll within a short period of time”) increase, especially for children.
Kids may be disenrolled from KanCare due to administrative churn or procedural reasons when the state doesn’t receive information about them to verify eligibility; this may occur due to system failures. Parents may never receive a notice even when their contact information is updated with the state, information they send into the state may never be successfully received, or they can’t get through to a call center to address issues.
These projections are deeply concerning and could mean that nearly three out of every four children losing their Medicaid coverage are still eligible for Medicaid or CHIP. Kids who lose their KanCare coverage due to procedural reasons, but remain eligible, would have to re-enroll. Waiting for coverage to restart would delay important, time-sensitive medical appointments, immunizations, screenings, and treatments. Delay in medical care for kids is serious — and, it will cost the state additional money to re-enroll these eligible kids again.
What KanCare enrollees need to do
For the next year, as the renewal process slowly returns back to normal operations, KanCare members and especially parents or caretakers of kids enrolled in KanCare must make sure they:
- Update KanCare member contact information with the state (go to kancare.ks.gov to update contact information online through the chatbot; or call 1-800-792-4884.
- Watch for, open, and respond to mail from the state by the requested deadlines.
CHIP Premium Payment Policy Enforced Again
Kansas families with children enrolled in CHIP coverage as part of KanCare, pay a $0, $20, $30, or $50 premium per household per month, depending on the family’s income level.
During the continuous eligibility period between March 2020 and March 2023, CHIP premium payment policies were not enforced, meaning that while some families may have still had a premium, payment delinquency was not considered for coverage continuance for the past three years. Beginning this April, however, timely premium payment will be required again for coverage to continue uninterrupted.
Premium notices were mailed on April 5; all prior premium balances prior to April 1, 2023, will be set to $0, so families will not have any outstanding balances or past-due amounts. CHIP premium payments are due on the first of each month and are considered past due after the last day of the month.
According to the state, families who do not pay their monthly premium are at risk of losing CHIP coverage for their children. Once a family has not paid their monthly premium for two months, then their account is considered delinquent. Once a child has their CHIP coverage ended for delinquency, they cannot re-enroll in the program for 90 days unless they qualify for Medicaid or pay the balance.
Click here for more details from the state, including premium payment options.
Kids’ health depends on regular access to quality care, and health insurance plays an important role in that access. Around 38,000 Kansas kids did not have health insurance in 2021, and administrative changes to KanCare this year are likely to increase the number of uninsured kids. If you can, share this information so all enrollees know about the changes and how they could impact their coverage.
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