Medicaid Redetermination

Many Americans could potentially lose their Medicaid coverage due to the end of a COVID-19 pandemic continuous enrollment rule. Insurance agents, including those who have clients on Medicare and Medicaid or who want to help people losing Medicaid coverage, can provide support to these individuals. Insurance agents can play a vital role in helping people understand the need for Medicaid redetermination so that they can respond in a timely manner.

ALL HANDS ON DECK…Many are unaware!

One of the significant concerns is that beneficiaries who enrolled in Medicaid during the pandemic may be unaware of the need to renew now because they were never exposed to the annual Medicaid renewal process. In addition, beneficiaries who have moved, are disabled or have limited English proficiency may be at greater risk of not receiving or understanding notices or responding when needed. This has led to an “all hands on deck” approach to reach the estimated 95 million people enrolled in Medicaid.

START WITH DUAL ELIGIBLE CLIENTS

For insurance agents, a logical place to start is with current clients who are “dual eligible”- people who qualify for both Medicaid and Medicare. They can help these clients go through the renewal process and contact their state Medicaid office to ensure it has their correct contact information. Once insurance agents know whether clients are Medicaid-eligible, they can connect them with available health care insurance options.

IMPACTED GROUPS- over 65 D-SNP and under 65 D-SNP

There are several groups that could be impacted by the end of continuous enrollment, including over-65 D-SNP clients who are losing Medicaid coverage, over-65 D-SNP clients who remain eligible for Medicaid benefits, under-65 clients who are dual eligible, and under-65 D-SNP clients who are losing Medicaid coverage but maintaining Medicare eligibility. Insurance agents can help these groups find suitable health care plans that provide coverage where Medicaid falls short.

It’s important for insurance agents to reach out to clients and even prospective clients to uncover opportunities to help, as helping someone find health care coverage could make a positive impact and provide stability for their future.

MAIN KEY POINTS TO KEEP IN MIND AS THIS PROCESS UNFOLDS:

1. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment provision.
2. It is estimated that between 5 million and 14 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision.
3. The Medicaid continuous enrollment provision has stopped “churn” among Medicaid enrollees.
4. States have developed plans for how they will approach the unwinding of the continuous enrollment provision.
5. Maximizing streamlined renewal processes can promote continuity of coverage as states begin to unwind the continuous enrollment provision.
6. States can obtain temporary waivers to pursue strategies to support their unwinding plans.
7. Certain groups may be at greater risk for losing Medicaid coverage during the unwinding period.
8. States can partner with MCOs, community health centers, and other partners to conduct outreach.
9. Timely data on disenrollment’s and other metrics will be useful for monitoring how the unwinding is proceeding.
10. The number of people without health insurance could increase if people who lose Medicaid coverage are unable to transition to other coverage.

It is important to keep in mind that the Medicaid program provides a critical lifeline to millions of people across the country, ensuring access to affordable healthcare is more important than ever. States will need to navigate this process carefully to avoid causing unnecessary harm to vulnerable populations. 

Please contact our Agent Support services for more information on how you can support your clients in this upcoming challenge.  https://brokers.taia.us/.