1

Enrollment 

& Renewal 

Checklist

Medicaid & CHIP

School District

Healthy kids reap benefits across many domains of their development, from academic performance, attendance, grades, 

cognitive skills, attitudes in-class behavior, and more.1 This academic year, school districts across the country will play a 

central role in protecting millions of children and youth from losing their Medicaid and Children’s Health Insurance Program 

(CHIP) coverage. Throughout the COVID-19 Public Health Emergency, the federal government required that states keep all 

beneficiaries enrolled in Medicaid or CHIP, without needing to complete the usual annual eligibility determination. As of April 

1, 2023, families once again were required to complete annual renewal paperwork to preserve and maintain their Medicaid 

CHIP coverage. The majority of children and youth will still be eligible for Medicaid/CHIP but may be at risk of losing their 

coverage if they do not act now to re-enroll. Each household will have a designated date for re-enrollment that may come any 

time throughout this school year. Barriers – like having outdated contact information, or not having access to information in 

their home language – may mean that some families are not yet aware that they are at risk of coverage loss, or they may have 

difficulty understanding the timeline or process for renewal.

 With more than half of all U.S. children and youth enrolled in Medicaid/CHIP2

, school-based health providers play a critical role 

in supporting students’ access to health care services. A new resource from the Centers for Medicare and Medicaid Services, 

Delivering Service in School-Based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming, 

provides direction to state Medicaid/CHIP agencies, districts, and schools on what they can do to make it easier to get paid 

for covered health services, thereby improving health care access for children and youth with Medicaid and CHIP coverage. 

Medicaid and CHIP can also cover the cost of administrative activities, including outreach and enrollment/re-enrollment in 

Medicaid. Contact your state’s Medicaid/CHIP agency to learn more about reimbursement for allowable outreach, enrollment, 

and renewal activities. 

Now is the time to inform and engage school communities to renew their Medicaid/CHIP coverage. The following checklist is intended 

to help school districts take immediate action to ensure that students maintain access to affordable health coverage.

 Build a team to help spread the word and provide support.

If one doesn’t already exist, assemble a team to carry out Medicaid/CHIP outreach, enrollment, and renewal activities. 

While each district is different, here are some key district and school staff to include in the effort:

n Superintendents. Leadership buy-in and support is key to the success of any districtwide effort. Superintendents 

can use their platforms to communicate with school officials and parents about the need to act to continue Medicaid 

coverage and can refer them to help and resources.

n School Principals and Assistant Principals. Principals and Assistant Principals oversee the day-to-day operations of 

the school and can ensure that school staff are informed and involved as needed.

n Assistant Superintendents and Student Deans. Deans and Assistant Superintendents are often responsible for 

coordination among school staff and can authorize your team’s outreach, enrollment, and renewal activities. 

n District Health Leaders, and School Nurses, and School Health Professionals. School nurses, psychologists, 

counselors, and social workers can include information about Medicaid enrollment in messages about student 

vaccines and school health policies, help identify students who need insurance, and assist parents who need help 

finding coverage.
2

n Education Support Professionals (ESPs) and Student Support Staff. ESPs, including student and family support staff, 

can help target outreach to students who may be at higher risk of losing coverage and/or need support transitioning 

coverage. These staff include, but are not limited to, family engagement staff, school nutrition staff, Special Education 

staff, Expanded Learning staff, Migrant Education Program staff, Local Homeless Education Liaisons, and Foster Youth 

Education Liaisons.

n State Medicaid Partners. Partner with your state’s Medicaid office to stay informed about your state’s eligibility 

guidelines and the enrollment process for health coverage through Medicaid, CHIP, and the Affordable Care Act 

Marketplace. To find contact information for your state’s Medicaid office, visit medicaid.gov/about-us/beneficiaryresources/index.html#statemenu.

 Prepare the team to disseminate information on Medicaid/CHIP changes and to support 

families with maintaining affordable health coverage.

n Articulate key messages. The following resources provide important information about recent changes to Medicaid/

CHIP and what districts and schools can do to help students maintain access to affordable health coverage.

• Visit Medicaid.gov/unwinding to access a robust set of resources that can be used to immediately distribute 

information to families, including posters, backpack fliers, robocall scripts, etc. Be sure to check out, Medicaid and 

CHIP Renewals: Reaching Children and Families in School-Based and Early Education and Care Settings, a toolkit 

designed to help district and school staff inform families about the recent Medicaid/CHIP changes and what they 

need to do avoid a gap in coverage. 

n Train staff to provide information and support. Given that each state has its own eligibility guidelines and enrollment 

process, it is important to partner with state Medicaid agencies or community partners to train the team about recent 

Medicaid/CHIP changes, what families need to do to maintain their health coverage, and how to support families who 

have lost coverage. 

n Take stock of existing infrastructure and capacity. Identify existing communication channels (e.g., newsletters 

and social media) and activities (e.g., back-to-school events and parent-teacher conferences) that can be leveraged 

throughout the school year to disseminate information about how to maintain health coverage on an ongoing basis. 

Leverage relationships with community organizations to help spread the word, particularly grassroots organizations that 

can serve as credible messengers to underserved communities.

n Develop an action plan. Building on the steps outlined above, create a plan for how your district will inform families 

about what they need to do to maintain coverage through Medicaid or CHIP, identify students who need health 

insurance, and provide support to obtain coverage.

 Take Action to Help Keep Students Covered.

n Start strong. Partner with local Medicaid agencies to conduct outreach activities during back-to-school events and 

consider incorporating information about Medicaid and CHIP into existing forms and processes. The toolkit above 

recommends including the addition of a check box to students’ emergency contact forms where parents can ask for 

more information or assistance. Districts and school can also add a banner on the main page of their website with a 

link to key resources, like LocalHelp.HealthCare.gov, where families can find help from someone in their area.

n Stay strong. States have up to 14 months to complete their renewal process, so it is important that district teams 

plan for ongoing communications and activities throughout the year and partner with state and local public health 

agencies to monitor enrollment and renewal progress.

1. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. 

“Health and Academic Achievement.” 2014. Atlanta, GA. cdc.gov/chronicdisease/index.htm

2. Performance Indicator Enrollment Data counts individuals receiving full-scope and comprehensive Medicaid and CHIP benefits. 

Data.Medicaid.gov