How to avoid being taken off Medicaid as states cut coverage


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As pandemic-era politics draw to a close, millions of people on Medical help can lose their coverage – even if they remain eligible, advocates say.

Over the past three years, due to the Families First Coronavirus Response Act, states were required to provide continued Medicaid coverage to enrollees in order to obtain federal funding. This meant that people on Medicaid could not be excluded from the program during this time.

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

Starting this month, however, states are resuming the usual process of redetermining eligibility, which could lead to hardship for millions of Americans, many of whom are already in a vulnerable position.

β€œThe Medicaid population is disproportionately low income, with chronic or debilitating illnesses, and they also change residence frequently or do not speak English as their primary language,” said Caitlin Donovan, spokesperson for the National Patient Advocate Foundation.

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The expiry of the continuous coverage could result in up to 14 million people losing their Medicaid coverage, according at the Kaiser Family Foundation. Almost 7 million people could be excluded from their plans even if they are still eligible.

“States may not have the right 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’ll still be eligible.

Be on the lookout for coverage reviews

In the coming months, states are likely to reach out to Medicaid recipients in several ways, Donovan said.

“People should always check their mail for notices from their national Medicaid agency, but they can also check emails, texts, phone calls, or even electronic portals where they can manage their care,” he said. she declared.

You’ll want to quickly provide all the information your state agency asks for, Donovan said, “It can keep you registered.”

Some of the notices 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 it will be crucial to communicate with your agency and make sure they have the latest information for you, she said.

“It’s going to be a confusing process for a lot of people,” Donovan said. “If you get a notice, don’t lose hope.”

You can appeal if you are abandoned, find new coverage

Your state should provide you with information about how to appeal your coverage decision, if they deem you ineligible, Donovan said. This process must take place within a certain period of time to avoid a too long interruption of your coverage.

Anyone who loses their call for Medicaid coverage could seek insurance in the public market, Donovan said, where a special enrollment period is open through July.

“The market has subsidies in place, so you should be able to find a zero monthly premium plan and even get some personal help,” she said.

In some states, former Medicaid enrollees may actually be automatically transferred to a market 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 taken off Medicaid shouldn’t assume their children are no longer eligible either, she said. Children may be eligible for Medicaid or Children’s Health Insurance Program at higher income levels than adults.

“Basically double-check everything,” Donovan said.

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