PHE Unwind Frequently Asked Questions
Does the renewal month change for pregnant people since they have 12 months of coverage following pregnancy?
Yes. The renewal month will be 12 months after the pregnancy ends. So if a member’s pre-pregnancy renewal is due in July 2023, but their pregnancy ends in September 2023, their new renewal date will become September 2024. Members must report their pregnancy in their PEAK account or to their county to qualify for the extended 12 months of coverage. Members can learn more by visiting the Health First Colorado webpage. Partners, please share this information. Printable flyers are available in English and Spanish.
How does the renewal process and end of continuous coverage impact individuals currently enrolled for the Family Planning Limited Benefit coverage who do not have full Health First Colorado (Medicaid) coverage?
Members enrolled in Family Planning Limited Benefits have an annual renewal date and will go through the renewal process to see if they still qualify. Members who are currently receiving the family planning limited benefits must request (opt-in) through PEAK or their county when it is their time to renew to continue receiving these benefits.
In some circumstances, the returned mail center (CRMC) will contact members to ask them to update their address. How will a member know if the state is calling and not a scam?
Calls coming from the CRMC will show up as "Prowers County" to landlines and 719-454-xxxx to cell phones (the last 4 digits change depending upon the line the call comes from internally). To learn more about how to recognize a scam, visit: hcpf.colorado.gov/alert
What happens if a member does not submit their renewal packet in time?
If the renewal packet is received too late to process within the member’s renewal month, the member may receive a notice that their coverage is ending. This renewal may be pending to be processed at the county and the member should contact their local county eligibility worker to confirm. Renewal packets submitted after the due date may result in a gap in coverage.
Can a member return their renewal packet late?
Members can resume medical coverage if they still qualify by returning their renewal packet and any missing information to their county for processing within 90 days of losing coverage. In PEAK, an item was added to the To-Do List to indicate when a late medical assistance renewal can be submitted and processed without needing a new application. Members are encouraged to return renewal packets if they miss the deadline rather than submitting new applications.
Can a member’s eligibility be backdated if they are disenrolled?
If a member is disenrolled for a procedural reason, they have a 90-day reconsideration period to submit their renewal packet. If they are determined still eligible during that 90-day period, coverage begins as of the 1st of the month they are determined eligible again. If there is a gap in coverage, members must request from the county to be enrolled retroactively. If a member is determined no longer eligible and they disagree with the decision, they can file an appeal.
More Frequently Asked Questions (FAQs) about the end of the continuous coverage requirement and return to regular renewal processes have recently been added and are available in the PHE Resource Center.
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