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Attention Medicaid Participants: Eligibility Renewals Restarted April 1, 2023
Important Information for Medicaid and CHIP Members
On April 1, 2023, the DHSS Division of Medicaid and Medical Assistance (DMMA) and the Division of Social Services (DSS) re-started annual Medicaid eligibility renewals.
Don't risk a gap in your health coverage. Take action to keep your Medicaid or CHIP benefits.
>Not all members will be renewed at the same time. Delaware will take 12 months (14 months including noticing) to renew members based on your annual renewal date. Some people will be automatically renewed based on the most recent information already on file with the state. Other people will need to take action and complete the renewal packet to see if they still qualify for Medicaid coverage.
There is assistance available and you may qualify for other high-quality insurance if you no longer qualify for Medicaid. This page will provide Information and resources for Medicaid members, health care providers and community partners.
An eligibility renewal, also called a Medicaid renewal, is a process that checks to see if a member is still eligible for Delaware Medicaid each year. This check is federally required.
Before the COVID-19 Public Health Emergency (PHE) that was declared in 2020, Delaware Medicaid would send Medicaid members an eligibility renewal form in the mail around the same time every year. During the COVID-19 PHE, renewals were not required, and members would only lose coverage if they requested to close, were deceased, or moved out of state. This meant that Delaware was required to continue Medicaid coverage for members, even if their eligibility changed. Since Medicaid coverage could not be ended, the eligibility renewal was not required.
Recent legislation signed by the federal government set a specific date to restart Medicaid eligibility renewals, despite the ongoing COVID-19 PHE. This means that Medicaid renewals are no longer tied to the COVID-19 PHE and will restart on April 1, 2023. If you want to read the legislation, called the Consolidated Appropriations Act, 2023, click here.
The most important thing you can do right now is to make sure Delaware Medicaid has your current contact information, and to make sure you report any name changes for you and anyone in your household. Your contact information includes mailing address(es), email address(es), and phone number(s). If you get a renewal letter, please follow the instructions before the deadline on your letter.
If your name or contact information has changed, you can report any changes by:
No. Eligibility renewals will restart in April 2023, but not everyone will get their renewal at the same time. Every Medicaid member will get a renewal at some point between April 2023 and April 2024.
Delaware Medicaid will first try to process your renewal without contacting you. If our team can verify your eligibility for Medicaid with the information available to them, you will simply get a letter in the mail notifying you that your renewal is complete and if you are still approved for healthcare coverage.
If we do not have enough information to verify your eligibility, you will need to complete an eligibility renewal form and/or provide additional verification documents. This form will be mailed to you, along with a letter with specific instructions and a deadline.
You can complete the form online through your ASSIST Self-Service account. Or you can complete, sign, and return the form by mail, by fax, or in-person.
If you need help completing your renewal form or need help in another language, you can contact the office listed on your renewal form.
You can also call the Customer Relations Unit at (302) 571-4900, Option 1 or 1-866-843-7212 (Monday through Friday, 8:00 a.m. to 4:30 p.m.). TTY users: 1-855-889-4325. Other languages: 1-866-843-7212.
First, make sure your contact information is up to date with Delaware Medicaid. Contract information includes your name, mailing address, email address, and phone number. If your name or contact information has changed, you can report any changes by:
If you still have questions, call the Customer Relations Unit at (302) 571-4900, Option 1 or 1-866-843-7212 (Monday through Friday, 8:00 a.m. to 4:30 p.m.). TTY users: 1-855-889-4325 Español, Kreyól ayisyen, or other languages: 1-866-843-7212
If you lose the eligibility renewal form that was mailed to you, immediately call the Customer Relations Unit at (302) 571-4900, Option 1 or 1-866-843-7212 (Monday through Friday, 8:00 a.m. to 4:30 p.m.). As soon as you get a new form in the mail, follow the instructions so we can process your information.
The amount of time it takes to process a renewal depends on if the application is complete and the type of Medicaid program. If your renewal form is complete and you have turned in all the required information, and you have not heard from Delaware Medicaid in 30 days, please contact the office listed on your renewal form.
When the renewal process is complete, we will send you a letter with the decision. There are three possible decisions:
Decision 1: Notice to Continue Your Benefits: We have checked your information and you are still eligible for Delaware Medicaid. Please check and make sure all the information on the letter is correct. If you need to make any changes, follow the instructions in your letter.
Decision 2: Notice About Your Medical Assistance: We have checked your information and have determined that you are still eligible for Delaware Medicaid, but you were determined eligible for a different type of coverage. Your letter will let you know what type of coverage you now have and will provide instructions if there is anything further you need to do.
Decision 3: Notice to Deny Your Medical Assistance: We have checked your information and have determined that you are no longer eligible for Delaware Medicaid. Your letter will let you know what the next steps are.
If you do not agree that you are no longer eligible for Medicaid coverage, you can contact the office on your letter with questions about the decision. You can also request a fair hearing using the directions on your Notice to Deny Your Medical Assistance letter.
Losing your Medicaid coverage can be scary. There are many resources and organizations that can help you.
You can visit ChooseHealthDE.com for information about available health insurance plans on the Health Insurance Marketplace.
In Delaware, there are two agencies with staff called Marketplace Navigators who will help you learn about and enroll in the health plans on the Federal Health Insurance Marketplace. These agencies are Quality Insights and Westside Family Healthcare. They can help you find and choose the best health insurance plan.
New Castle County: 302-472-8655
Kent or Sussex Counties: 302-678-2205
www.westsidehealth.org/marketplace/
1-844-238-1189
www.DEHealthPlanConnect.com
Delaware 211 (United Way) can help connect you to resources throughout the state.
Their services are free, confidential, and available in multiple languages.
Visit their website https://delaware211.org/
Call 211 or toll free 1-800-560-3372 (Monday through Friday, 8:00 a.m. to 9:00 p.m. and Saturday, 9:00 a.m. to 5:00 p.m.)
Text your zip code to 898-211 or chat online at https://delaware211.org/
Email info@delaware211.org
You can log onto ASSIST Self-Service to sign up for text messages and/or emails about your benefits.
For more information, visit de.gov/medicaidrenewal
If you have general Medicaid renewal questions, you can call the Customer Relations Unit at (302) 571-4900, Option 1 or 1-866-843-7212 (Monday through Friday, 8:00a.m. to 4:30 p.m.). TTY users: 1-855-889-4325. Other languages: 1-866-843-7212.
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