New Frequently Asked Questions (FAQs) Regarding Ex Parte
How many members will be reinstated due to the change in ex parte guidance?
We initially identified 10,044 individuals affected by this change. The number of members may change slightly once we finalize the reinstatement process.
Will HCPF be doing ex parte at the individual level by default as of October 2023?
Yes. Renewal packets will still be sent to households, but individuals within that household who are identified as eligible during ex parte will be approved instead of disenrolled if the household fails to return their renewal packet by the deadline.
When will members find out if they have coverage reinstated?
We will be sending letters to affected members the week of Oct. 30, 2023.
What does the letter to members telling them they have coverage again look like?
See a sample reinstatement letter in English and Spanish.
Why does a child/someone in a household now qualify for coverage again but another person still does not?
There are different eligibility rules for people in a household depending on their situation. For example, the income limit for children to qualify for coverage is higher than the income limit for adults. So it is possible for a child to be approved and a parent to not qualify for coverage.
Are members who were disenrolled as a result of the CMS mandated change to ex parte, but later approved and reinstated guaranteed coverage until their next renewal date?
Reinstatement in coverage does not guarantee that adults will remain covered until their next annual renewal date. Changes in circumstances such as getting a new job may result in someone no longer qualifying for Health First Colorado or CHP+. However, this does not apply to children, pregnant or postpartum people as they are guaranteed coverage until their next renewal date regardless of changes in circumstances. If a person had coverage reinstated, but then reported changes that made them ineligible, they will receive one letter telling them that they qualify for a certain date but then no longer qualify for another date and the reasons for that. The letter will provide the dates they qualify and whether or not they currently qualify.
What should a reinstated member do if they have incurred medical expenses while they had a gap in coverage?
If a member incurs medical bills during the time we said that members of the household were not covered, let us know so we can pay them. Members can call customer service and let them know about these bills:
- Health First Colorado members, please call 800-221-3943 (State Relay: 711)
- CHP+ members, please call 800-359-1991 (State Relay: 711)
Additional FAQs about the end of the continuous coverage requirement and return to regular renewal processes are in the PHE Resource Center.