Change in Medicaid or SCHIP Eligibility

Change in Medicaid or SCHIP Eligibility

When your eligibility for Medicaid or the State Children's Health Insurance Program (SCHIP) changes, you have 60 days from the time you lose or gain eligibility to make a corresponding change to your MIT health-related benefits.

Your Options

You lose — or gain — Medicaid or SCHIP Eligibility. What are your options?

  • Within 60 days, enroll yourself or your dependent in an MIT health, dental, or vision plan — or withdraw from one, if you will be enrolling in a Medicaid or SCHIP plan.
  • When you terminate your enrollment in an MIT group health plan, your children's enrollment will be terminated, too.
  • Within 60 days, enroll in an MIT Health Care Flexible Spending Account (FSA) or change the amount of your contribution.

If you don't notify the MIT Benefits Office of your change in eligibility within 60 days, you must wait until the annual Open Enrollment period to make any changes to these health and medical plans.

What the Federal Statute Says

The ability to change your health-related benefits outside the designated open enrollment period is the result of CHIPRA, the Children's Health Insurance Program Reauthorization Act of 2009. CHIPRA states that all group health plans must permit eligible employees and their dependents to enroll in an employer plan outside of the established open enrollment period if the employee requests enrollment under the employer's group health plan within 60 days of either:

  • Loss of coverage due to loss of eligibility under Medicaid or a State Children's Health Insurance Program (SCHIP). If you or your dependent lose coverage under Medicaid or SCHIP, you may enroll yourself and your dependent in an MIT group health plan no later than 60 days after coverage ends under Medicaid or SCHIP.
  • Eligibility for premium assistance under Medicaid or a State Children's Health Insurance Program (SCHIP). If you and/or your dependent become eligible for financial assistance from Medicaid or SCHIP, you may enroll yourself and/or your dependent in a group health plan available through MIT, provided that your request is made no later than 60 days after the date that Medicaid or the State Children's Health Insurance Program determines that you and/or your dependent are eligible for such financial assistance. If you and/or dependent are currently enrolled in an MIT group health plan, you have the option of terminating your and/or your dependent's enrollment in the MIT group health plan and enrolling in Medicaid or SCHIP. Once you terminate your enrollment in the MIT group health plan, your child/children's enrollment will be terminated as well.

Don't Forget

Failure to notify the MIT Benefits Office of your loss of eligibility for coverage or eligibility for premium assistance under Medicaid or SCHIP within 60 days will prevent you from enrolling in an MIT health plan and/or making any changes to your coverage elections described above until MIT's next Open Enrollment period.