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Transitioning from Medicaid to marketplace coverage in 2023

The process of termination (unwinding) of Medicaid coverage for those enrolled in the program because of the Covid Public Health Emergency begins on April 1, 2023. 

The Department of Health and Human Services began evaluating eligibility of enrolled recipients on Feb. 1, reviewing household monthly income, age, employment status, and changes in family size. As a result, many people will discover they are no longer eligible for full Medicaid coverage. Consumers are therefore strongly encouraged to apply for coverage through the Health Insurance Marketplace, or, where insurance plans are available. Most people can qualify for a plan that costs less than $10 a month. 

Mountain Projects has expert insurance counselors on staff to help create an account, navigate the application, and determine eligibility for tax credits, all at no charge. This program is called GetCoveredWNC. Appointments can be made by calling 828.452.1447. 

The “unwinding” of Medicaid will not happen all at once. NCDHHS has 14 months to complete the recertification process. There are an estimated 300,000 North Carolinians who could lose their Medicaid between March 31, 2023, and July 31, 2024. DSS workers will be referring consumers to organizations like Mountain Projects to check their eligibility for Marketplace plans on

Persons losing Medicaid will begin receiving notices as early as February and should contact Mountain Projects’ GetCoveredWNC counselors to create an account on in advance of April 1, 2023, to avoid a lapse in coverage when their Medicaid ends. 

A person who loses Medicaid may be eligible for $0 monthly premiums on the Health Insurance Marketplace. (MP) The MP cannot turn someone away because of preexisting conditions; and plans cover most services that Medicaid covers. 

The Mountain Projects team of Certified Application Counselors is available to screen and enroll consumers in all seven counties of Western NC and the Qualla Boundary throughout the unwinding phase. 

People who lose Medicaid and Children’s Health Insurance Program (CHIP) coverage any time between March 31, 2023, and July 31, 2024, will be eligible for a Marketplace SEP. After a person is deemed eligible for the Marketplace subsidies, they will have 60 days to choose a plan, and their coverage will start the first day of the month after they choose a plan. 

This opportunity allows people who lose Medicaid or CHIP to get enrolled anytime between March 31, 2023, and July 31, 2024, no matter when their Medicaid ended. 

The SEP is triggered when someone answers “yes” to the application questions asking if their Medicaid/CHIP coverage ended recently or will end soon. People will not be required to supply documentation to verify their loss of Medicaid/CHIP. 

Contact Certified Application Counselors by County: 

• In Haywood County: Jane Harrison, Vicky Gribble and Jan Plummer, Coordinator: 828.452.1447 at Mountain Projects, Inc. 2177 Asheville Road in Waynesville. 

• In Jackson County:  Marilyn Tollie (bilingual assistance in all counties) 828.550.3686; and Susan Rose: 828.476.9194 located at 154-B Medical Park Loop in Sylva. 

• In Swain and Graham Counties: Linda Fitzsimmons: 828.550.7908. 

• In Macon County: Cynthia Solesbee: 828.400.4177. 

• In Clay and Cherokee Counties: Linda Curtis-Palmieri: 828.400.3149. 

Appointments are available in-person, by phone, or by video call. 

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