How Do I Declare a Gain of Medicaid Event?
If you or any of your enrolled dependents gain Medicaid coverage, you must declare the event by notifying SHBP Member Services of your gain of coverage by taking the following steps:
Within 31 days of your gain of Medicaid coverage...
Within 31 days of your gain of Medicaid coverage, you must declare the event by notifying SHBP Member Services by:
- Visiting the SHBP Enrollment Portal 24 Hours a Day/7 Days Per Week (for instructions on registering or logging in the SHBP Enrollment Portal, click here), or
- Contacting SHBP Member Services at 800-610-1863, Monday – Friday 8:30 a.m. to 5:00 p.m. ET and Saturday 8:00 a.m. to 5:00 p.m. ET
If you fail to timely notify SHBP Member Services, you must wait until the next Open Enrollment period, unless you experience another Qualifying Event or Special Enrollment Event to make a change to your coverage.
Within 45 days after you notify SHBP Member Services...
Within 45 days after you notify SHBP Member Services, you must provide a letter from Medicaid documenting name(s) of everyone who gained coverage, date of the gain of coverage, and reason for the gain of coverage.
To assist you in providing the verification documentation...
To assist you in providing the verification documentation, our Dependent Verification Services (DVS) team will send you a letter with a unique bar code from SHBP within 1 to 2 business days via email if you have an email address on file; and if no email address is on file, the letter will be mailed to you within 2 to 4 business days if you have an address on file. This process is referred to as your DVS Audit and you and/or your dependent(s) as applicable, will not be enrolled in SHBP coverage until you provide the necessary verification documentation proving eligibility for coverage and the DVS team approves your Audit.
Please do not submit verification documentation until you receive your letter from DVS. Providing documentation to anyone, including your employer or other entity not appointed by SHBP for this purpose, or via any other means not provided for in this letter will result in you failing the DVS Audit. If you fail the DVS Audit, you must wait until the next Open Enrollment period, unless you experience another Qualifying Event or Special Enrollment Event to make a change to your coverage.
Need to Speak with Someone?
If you need to speak with a member of the DVS team, please contact SHBP Member Services via email at [email protected] or via phone at 800-610-1863 and select the appropriate prompt for Dependent Verification Services.