Know How to Help Clients Dually Enrolled

Understanding Your Role in Medicaid/CHIP Periodic Data Matching

CMS conducts periodic data matching (PDM) to determine if consumers are dually enrolled in Marketplace coverage with advance payments of the premium tax credit (APTC) and in Medicaid or the Children’s Health Insurance Program (CHIP). If consumers are identified as dually enrolled, they will receive notices from CMS asking them to immediately end their Marketplace plans with APTC.

Consumers who receive these notices may contact you for the following reasons:

  • Help understanding the notices
  • Help responding to the notices by ending their Marketplace coverage or updating their application
  • If they don’t think they are enrolled in Medicaid/CHIP
  • If they believe they are eligible to remain enrolled in a Marketplace plan with APTC

For more information about the Medicaid/CHIP PDM process and how you can help consumers, check out the slides from the March 22 “Medicaid/CHIP PDM: An Overview for Agents and Brokers” webinar.

Agent/Broker Email Help Desk (for policy questions, escalated registration questions, issues with ID proofing, the Registration Completion List, and Find Local Help), available Monday – Friday, 8:00 AM – 8:00 PM ET

If you have any questions, please call us toll-free (888) 539-1633.

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