Medicaid Redetermination: Resources to Help Patients Who May Lose Coverage

Millions of Americans are expected to lose their Medicaid-related health coverage due to the continuous enrollment requirement for Medicaid, which ended on March 31, 2023. This will be a disruptive, stressful time for our members and your patients affected by this change.


In response to the COVID-19 pandemic, the federal government declared a Public Health Emergency (PHE) on January 31, 2020. Income eligibility requirements for Medicaid were waived, to help millions of Americans who lost their employer-sponsored health insurance.

In December 2022, Congress passed its year-end omnibus spending bill, which delinked the Medicaid continuous coverage requirement from the PHE, establishing the date of April 1, 2023, for resuming Medicaid redetermination. As states begin reviewing eligibility requirements for Medicaid, many current recipients will be disenrolled.

Available Resources to Share with Your Patients

The resources below might help members/patients who no longer qualify for Medicaid-related coverage find affordable health care coverage:

Highmark Resources for Members/Patients

 Region  Number  Website
 Delaware  833-585-7334
 New York (Northeastern)  800-700-8482
 New York (Western)  800-888-5407
 Pennsylvania (Central)  833-585-7332
 Pennsylvania (Northeastern)  833-585-7333
 Pennsylvania (Western)  833-585-7331
 West Virginia  833-585-7335

FAQs on the PRC

For more information on the Medicaid redetermination process, you can view the Frequently Asked Questions (FAQs) document on the Provider Resource Center (PRC).

To access the FAQs, go to the PRC, select COVID-19 from the left menu and then click COVID-19 (Coronavirus) Information. Once on the page, the FAQs can be found under the Medicaid Redetermination section.