The Public Health Emergency (PHE) and Extended Medicaid Coverage: Q & A for Florida Medicaid Recipients

What is the PHE and extended Medicaid coverage?

During the national COVID-19 Public Health Emergency (PHE), which is still going on, virtually no one
enrolled in Medicaid as of March 2020 or later can be terminated from coverage. Thus, people who are
no longer eligible for Medicaid have stayed covered and will remain covered until the PHE ends.

Are there any exceptions that would cause someone to lose Medicaid during the PHE?
The only exceptions are if you move out of Florida or ask to be disenrolled.

What are some examples of people who are still on Medicaid because of the PHE?

Low-income parents who no longer have a child under 18

Under normal Medicaid rules, if you are on Medicaid because you are a low-income parent, your
Medicaid eligibility ends when you no longer have a(ny) minor child(ren). Thus, if you were on Medicaid
in March 2020 and your youngest child turned 18 in April 2020, you are no longer “technically eligible”
for Medicaid coverage as a low-income parent. However, due to the emergency PHE rules, you still have
Medicaid coverage.

Families no longer eligible for Medicaid due to increased income

Under normal Medicaid rules, the income limits are higher for children than parents and highest for
infants than children between 1 and 18. Here is an income chart. Under normal rules, if the family’s
income increases above the income limit(s) for various family members, that family member’s Medicaid
eligibility ends.

For example, Jane, a single parent with a 3-year-old and a 10-year-old lost her job in April 2020 and
enrolled the entire family in Medicaid. Even though Jane got another job in June 2020 with a monthly
income of $1800, or about 100% of the federal poverty level, everyone remained on Medicaid due to the
emergency PHE rules. Under Florida’s normal rules, Jane would no longer be eligible since the income
limit for parents is at about 32% of FPL, or $577 for a family of 3. (Under the normal Florida rules, the
children would still be eligible because the family income is under the limit of 138% of the FPL.)

Individuals eligible for disability related Medicaid whose Medicare has started

Under Florida’s normal Medicaid rules, individuals found disabled and whose income is less than 88% of
the FPL (or $945/mo), are enrolled in Medicaid. However, they lose their full Medicaid coverage when
they are enrolled in Medicare. Typically, there is a 2-year waiting period before Medicare begins after a
person is found disabled.

For example, John, who was found eligible for disability-related Medicaid in May 2018 began receiving
Medicare in May 2020. Under normal Medicaid rules, when he enrolled in Medicare, he would have
been terminated from full Medicaid. Depending on income, he would be transferred to a Medicare
Savings Program that covers certain costs that come with Medicare. However, due to the PHE, John is still
on full Medicaid, along with Medicare.

What will happen when the public health emergency ends?
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The Department of Children and Families (DCF) will look at your case to see if you are eligible for a
different type of Medicaid. There are different groups of people who may be eligible including children,
parents and caretakers of minor children, pregnant women, new mothers, individuals 65 and older and
people determined disabled by the Social Security Administration.

DCF may ask you for additional information while it goes through this process to see if you are still
eligible, and you must respond promptly. If DCF thinks that you are not eligible for Medicaid under any
category, your Medicaid will end, and you will be sent a notice with your appeal rights.

What are some things you can do before the PHE ends?

● If you get a letter from DCF telling you that you must complete your annual eligibility review, follow
the instructions in the letter. This will help make sure your coverage is correct once the PHE ends.
● If there are changes to your household (loss of income, new income changes in who is living in your
home) report them to DCF immediately. This will help make sure your coverage is correct once the
PHE ends.
● If you are receiving family-related Medicaid, and you are disabled: you should apply for benefits
with the Social Security Administration as soon as possible. Here is information on applying.
● If you have not done so, create an online account if possible here, and make sure all your
information, including your address is updated.
● If you get a letter from DCF saying that your Medicaid eligibility has been reviewed and even though
you are no longer eligible DCF is keeping you on Medicaid to “make sure you have coverage during
the PHE.” (Notice). If you think you might still be eligible, you should contact DCF and provide any
updated information that might make you eligible.
● Medicaid is complicated! The Florida Health Justice Project will be providing updated information
about what happens regarding Medicaid eligibility after the PHE ends. In the meantime, if you were
on Medicaid as of March 2020 and it was terminated, contact DCF to correct your case, and if you
still have questions or issues, contact FHJP by emailing info1@floridahealthjustice.org.

FHJP is grateful to DCF for their help in creating this document. However, please note that this is not an
official statement. Also, the situation discussed here may change in coming months. Enrollees can reach
out to DCF as well as FHJP if they have questions.

For additional information, contact Miriam Harmatz, harmatz@floridahealthjustice.org. 10/21/21

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