How to avoid being dropped from Medicaid if

Norman Ray

Global Courant 2023-04-19 22:41:47

Pattanaphong Khuankaew | EyeEm | Getty Images

As a pandemic-era policy winds down, millions of people move on Medicaid may lose their coverage — even though they remain eligible, lawyers say.

For the past three years, due to the Families First Coronavirus Response Act, states are required to provide ongoing Medicaid coverage to enrollees in order to receive federal funding. That meant people on Medicaid couldn’t be dropped from the program during that time.

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“From March 2020 to March 2023, people could only enter Medicaid, and no one was at risk of losing coverage,” he said. Kosali Simonprofessor of health economics at the O’Neill School at Indiana University.

However, starting this month, states are resuming the usual re-eligibility process, which could spell trouble for millions of Americans, many of whom are already in a vulnerable position.

“The Medicaid population is disproportionately low-income, with chronic or debilitating conditions, and they also frequently move homes or do not speak English as their primary language,” said Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation.

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The expiration of the continuous coverage provision could cause as many as 14 million people to lose their Medicaid coverage, according to to the Kaiser Family Foundation. Nearly 7 million people could be dropped from their plans even though they are still eligible.

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“The states may not have the correct contact information for them, or even if they do,[enrollees]may not realize what the forms are when they get them in the mail,” Donovan said.

Here’s how to avoid losing your Medicaid coverage if you think you’re still eligible.

Watch for coverage notices

In the months ahead, states will likely contact Medicaid beneficiaries in a variety of ways, Donovan said.

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“People should always check their email for messages from their national Medicaid agency, but they can also check email, texts, phone calls or even e-portals where they can manage their care,” she said.

You want to quickly provide all the information your government agency asks of you, Donovan said, “You might stay enrolled.”

Some of the messages states send to people are confusing, Donovan said.

For example, she said a state told someone they were no longer eligible for Medicaid, but then said their eligibility was still being determined. That’s why communicating with your agency and making sure they have the latest information for you is crucial, she said.

“This is going to be a confusing process for a lot of people,” Donovan said. “When you receive word, don’t give up hope.”

You can appeal if you get dropped off, take new cover

Your state should provide you with information about how to appeal against your coverage decision, if they find you ineligible, Donovan said. That process has to unfold within a certain time frame to avoid too big a hole in your coverage.

Anyone who loses their appeal to Medicaid coverage can seek insurance from the public exchange, Donovan said, where a special enrollment period is open through July.

“The market has subsidies, so you should be able to find a zero monthly plan and maybe even qualify for cash assistance,” she said.

In some states, former Medicaid enrollees may be automatically transferred to a marketplace program, Donovan said: “Every state is different.”

Donovan is particularly concerned that millions of children will become uninsured in the coming months.

Parents who are dropped from Medicaid should not assume that their children will also become ineligible, she said. Children may be eligible for Medicaid or the Health insurance program for children at higher income levels than adults.

“Basically, double check everything,” Donovan said.

How to avoid being dropped from Medicaid if

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