Medicaid Renewal Notices

What You Need to Know About Medicaid Renewal Notices

On April 1, the State of Rhode Island began eligibility renewals for Rhode Islanders who have Medicaid. As required by federal law, the State won’t renew everyone at once. You’ll receive a notice from us sometime between April 2023 and April 2024. 

Like many other states, Rhode Island chose to delay renewals for households with kids to allow more time for thoughtful outreach, engagement, and preparation. As a result, households with kids will get their renewal notice between December 2023 and April 2024. 

To view your anticipated renewal date, use this lookup portal or log in to your account at healthyrhode.ri.gov. Notices will arrive about two months before your Medicaid renewal date.

Medicaid Renewals Letter

Everyone who will have their Medicaid eligibility reviewed by the State should have received the Medicaid renewals letter in March. This letter told you about the Medicaid renewal process and how important it is to make sure we have the correct contact information for you. If you didn’t get this letter in your mailbox or in your account at healthyrhode.ri.gov, please check your contact information right away.

Sample Envelope and Notices

All renewal notices will come in a white envelope from the State of Rhode Island that says, "Time Sensitive--Open Immediately." Most people will get a yellow notice. Some people will get a green notice. 

Time sensitive open immediately

Below are samples of the different notices the State will send. You won’t get every one of these notices. We’ll use the information we know about your household to decide which notice(s) you should get.

Recertification/Renewal Notices

If we have enough information about your household to complete your renewal, you’ll get this yellow notice when it’s your turn to renew. It says: “The people listed below will be automatically renewed for Medicaid.”

What you must do: Check all the information in the notice and tell us if there are any changes or errors. If the information is correct, you don’t need to do anything else. If the information is not correct or if you have new information to provide, you must tell us. Follow the instructions in your notice about how to tell us about changes.

If we don’t have enough information about your household or if we think you may no longer be eligible for Medicaid, you’ll get this yellow notice when it’s your turn to renew. It says: “Action Required. The individuals listed below are up for Medicaid renewal. Some of these individuals may no longer be automatically renewed for Medicaid based on the current information in your account.”

If you get this notice, you’ll also receive a white Additional Documentation Required notice. This notice will arrive separately from the yellow notice.

What you must do: When you receive the white Additional Documentation Required notice, gather the documents listed on your notice. Provide your signed Medicaid renewal notice AND any required documents to us before the due date on the yellow notice.

This white notice tells you which documents you need to provide to us. You will get this white notice only if you receive a yellow Medicaid renewal notice that says Action Required.

What you must do: Gather the documents we ask for in the notice and submit them to us by mail, in person, or electronically at www.healthyrhode.ri.gov. Don’t forget to send your signed Medicaid renewal notice too. Follow the instructions in your notice about how to provide these documents.

If you received the yellow Medicaid Recertification/Renewal Notice (Action required), we’ll send this reminder notice as your due date gets closer.

What you must do: Submit the documents shown in your Additional Documentation Required Notice, along with your signed Medicaid Renewal Notice, by the due date on your yellow notice. It’s important to do this by the due date to avoid a gap in Medicaid coverage.

When you have submitted the documentation we asked for, we’ll send this thank you notice to let you know that we have your documents.

What you must do: You don’t need to do anything. You have successfully submitted your documents.

Special Circumstance Notices

If you have a special circumstance that affects your eligibility, you won’t receive a yellow Medicaid renewal notice. If we know you’re part of this group, you’ll receive a green Special Circumstance notice.

What you must do: Follow the instructions in your Special Circumstance notice.

Ex-Parte Notices

If you’ve had certain life changes, you may get a Medicaid ex-parte notice. An ex-parte notice means:

  • We’ve determined you’re no longer eligible for Medicaid because of these changes.
  • We’ve ended your Medicaid eligibility.

You may get an ex-parte notice if you:

If you get this notice, you may able to get Medicaid in another eligibility category. Check your notice for instructions on how to apply.

Benefits Decision Notice

When we have processed your renewal packet (including any required documents), you’ll receive a Benefits Decision Notice. You may receive:

If your Benefits Decision Notice says, “Your health coverage is being renewed,” we have approved your Medicaid eligibility.

If your Benefits Decision Notice does NOT say “Your health coverage is being renewed,” your Medicaid eligibility has been terminated. Be sure to read the entire Benefits Decision Notice to learn more about health plan options and any financial assistance you may be eligible for.

If we determine you are eligible for financial assistance in getting health coverage, this assistance could include:

  • Auto-enrollment in a HealthSource RI plan.
  • Two months of premium assistance from the State of Rhode Island.
  • Certain tax credits.

If you don’t agree with our decision about your Medicaid eligibility, you have the right to appeal. Your Benefits Decision Notice tells you how to appeal.

Other Notices You May Receive

A small number of members who received a benefits determination notice earlier than expected received this notice to inform them that their coverage was extended. 

Notices for Specific Populations

Some members are in the Complex Medicaid eligibility category. These include the Long-Term Services and Supports (LTSS) and/or Medicare Premium Payment (MPP) programs.

It’s important to know that if you were eligible for Supplemental Security Income (SSI) on March 31, 2023, you’re automatically eligible for Medicaid and will not receive a Medicaid recertification/renewal notice.

If you were not eligible for SSI on March 31, we will check your Medicaid eligibility by sending a Recertification/Renewal Notice. See below for more information about these notices.

If you’re enrolled in the long-term services and supports (LTSS) program, you’ll receive a yellow Recertification/Renewal Notice. In 2023, your renewal eligibility will be based only on financial eligibility. We will not evaluate clinical eligibility for LTSS in 2023.

Recertification/Renewal Notice (Report Changes Only)

If we have enough information about your household to complete your renewal, you’ll get a yellow LTSS Recertification/Renewal notice when it’s your turn to renew. It says: “Review the Information We Have on File for You. The people listed below will be automatically renewed for Medicaid.”

What you must do: Check all the information in the notice and tell us if there are any changes or errors. If the information is correct, you don’t need to do anything else. If the information is not correct or if you have new information to provide, you must tell us. Follow the instructions in your notice about how to tell us about changes.

Recertification/Renewal Notice (Action Required)

If we don’t have enough information about your household or if we think you may no longer be eligible for Medicaid, you’ll get this yellow LTSS notice when it’s your turn to renew. It says: “Action Required. Review the Information We Have on File for You.”

The notice will include a list of documents you must provide. If you get this notice, you’ll also receive a white Additional Documentation Required notice. This notice will arrive separately from the yellow notice.

What you must do: When you receive the white Additional Documentation Required notice, gather the documents listed on your notice. Provide your signed Medicaid renewal notice AND any required documents to us before the due date on the yellow notice.

If you’re enrolled in the Medicare Premium Payment (MPP) program, you’ll receive a yellow Recertification/Renewal Notice.

Recertification/Renewal Notice (Report Changes Only)

If we have enough information about your household to complete your renewal, you’ll get a yellow MPP Recertification/Renewal notice when it’s your turn to renew. It says: “Review the Information We Have on File for You. The people listed below will be automatically renewed for Medicare Premium Payment coverage.”

What you must do: Check all the information in the notice and tell us if there are any changes or errors. If the information is correct, you don’t need to do anything else. If the information is not correct or if you have new information to provide, you must tell us. Follow the instructions in your notice about how to tell us about changes.

Recertification/Renewal Notice (Action Required)

If we don’t have enough information about your household or if we think you may no longer be eligible for Medicaid, you’ll get this yellow MPP notice when it’s your turn to renew. It says: “Action Required: Review the Information We Have on File for You.”

The notice will also include a list of documents you must provide. If you get this notice, you’ll also receive a white Additional Documentation Required notice. This notice will arrive separately from the yellow notice.

What you must do: When you receive the white Additional Documentation Required notice, gather the documents listed on your notice. Provide your signed Medicaid renewal notice AND any required documents to us before the due date on the yellow notice.

During the Public Health Emergency (PHE), the State of Rhode Island, under federal guidance, ended Medicaid eligibility for certain individuals. A judge later decided that Medicaid coverage should not have ended and issued new federal guidance to reinstate benefits.

If this guidance and decision affected you, we have reinstated your Medicaid benefits. You will stay covered until it is your turn to renew your eligibility. You don’t have to take any action until you receive your yellow Recertification/Renewal notice.

If we reinstated your Medicaid coverage, you’ll also receive a Medicaid reimbursement letter and Medicaid reimbursement request form. If you had to pay any medical bills during the time your Medicaid coverage ended, you should fill out the reimbursement request form.

Follow the instructions in the letter. Send us the form, along with copies of receipts for all medical services. We will use this information to see if we can give you money back to cover your medical expenses.

Master List of Information Changes That Can Be Reported (pending)

Master List of Documentation That Can Be Requested (pending)