Medicaid Eligibility Reviews To Resume Beginning April 1, 2023

Since March of 2020, NJ Medicaid has followed special rules related to the federal COVID-19 Public Health Emergency (PHE). These rules have allowed most NJ Medicaid recipients to keep their health coverage, even if they no longer qualified – for example, if their income was too high. However, once the federal government determines that the PHE is over, NJ Medicaid will have to follow normal federal rules governing continuing eligibility for Medicaid benefits.

The PHE is expected to end soon. As a result, states are now required by the federal government to resume Medicaid eligibility processes beginning April 1, 2023. On that date, NJ Medicaid will begin “unwinding.” This means that all recipients enrolled in NJ Medicaid programs will be reviewed to see if they still qualify for coverage. Stated another way, “unwinding” is the process in which New Jersey will restart yearly eligibility reviews for everyone enrolled in NJ Medicaid.

As part of the “unwinding,” many Medicaid recipients will receive mail from the State of New Jersey or their County Board of Social Services. Recipients will have to provide or confirm additional information so NJ Medicaid can decide whether they still qualify for healthcare coverage. Recipients who do not respond to NJ Medicaid mail will lose their coverage.

New Jersey is anticipating further guidance from the federal Centers for Medicare & Medicaid Services in early January concerning the procedures to follow in the “unwinding” review process.

During the unwinding, NJ Medicaid will send renewal packets for recipients to complete and return. Then, NJ Medicaid will decide if recipients still qualify for coverage. Recipients who still qualify will keep their NJ Medicaid coverage. Recipients who don’t qualify will be terminated from Medicaid.

What can Medicaid recipients do to prepare for the end of the PHE?
• Call NJ Medicaid at 1-800-701-0710 (TTY: 711) to update their contact information. This is especially important if they have moved in the last three years.
• Watch for mail from the State of New Jersey or your county, and make sure to reply on time to avoid a gap
in coverage.

I posted a blog article about the then-upcoming end of the COVID-19 Public Health Emergency here –

A recent email message from Jennifer Langer Jacobs, the Assistant Commissioner of the Division of Medical Assistance & Health Services, which is New Jersey’s state Medicaid agency, explaining the “unwinding” process, is annexed hereto:

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UPDATED 2/23/23Majority of Beneficiaries Surveyed Not Aware of Looming Medicaid Eligibility Redeterminations (From he National Academy of Elder Law Attorneys eBulletin for February 2023)

A new Urban Institute survey shows that a majority of Medicaid beneficiaries surveyed weren’t aware of the need to redetermine their eligibility. A recent survey of adults found more than 60 percent are not aware their eligibility for Medicaid could be in danger, underscoring the massive task states and managed care plans face ahead of an April 1 deadline. The analysis, published by the Robert Wood Johnson Foundation, looks at the awareness at the end of 2022 of the looming Medicaid eligibility redeterminations. The survey, conducted by the think tank Urban Institute, showed awareness was lacking across the country regardless of the area. Researchers gleaned the results from Medicaid beneficiaries surveyed in the December 2022 Well-Being and Basic Needs Survey, which surveys more than 8,000 adults every year on how they are meeting basic needs such as food and medical care. The results showed that 64.3 percent of Medicaid beneficiaries surveyed weren’t aware of the looming renewal process, virtually unchanged from a similar analysis back in June that found 62 percent of adults were not aware.

The Urban Institute survey is attached here – [gview file=””]

UPDATED 3/28/23 – The New Jersey Department of Human Services, Division of Medical Assistance and Health Services (DMAHS) is the state Medicaid office. DMAHS recently issued MEDICAID COMMUNICATION NO. 23-03 entitled “COVID-19 Public Health Emergency (PHE) Unwinding Guidance Effective April 1, 2023″ which describes the procedures to be followed by the State in returning to normal Medicaid rules.

MEDICAID COMMUNICATION NO. 23-03 is annexed hereto – [gview file=””]

For additional information concerning Medicaid applications and appeals, visit:

NJ Medicaid Applications