Medicaid Redeterminations Resume: What To Know

Estate Planning Lawyer

During the COVID-19 pandemic, a pause was put into place regarding the process of rechecking Medicaid eligibility for current enrollees. This process is called Redetermination. After three years, all states have resumed rechecking eligibility with the penalty of disenrollment as of April 1, 2023, with some states beginning redeterminations in February 2023.

This time can be stressful and unsure for those who rely on the support of Medicaid and are uncertain that they will remain eligible. An experienced estate planning lawyer from McCarthy Law, LLC stresses the importance of remembering to do the following as this process continues:

Eligibility for Medicaid did not change for everyone.

Eligibility is based on each individual state’s criteria. Most states base their decisions on current income levels and assets. Changes in circumstances that have occurred since your enrollment may affect your eligibility. Be sure to report any change in income or assets to your state program as they occur. If you are no longer eligible for your current Medicaid program, you could be transferred to another that better fits your needs.

Update your contact information.

In many cases, a form was sent out to ensure that all information is up to date. If your address or phone number filed with the Medicaid agencies is not the most recent version, you may be missing out on important communications regarding your status. This will help to avoid any unnecessary terminations. 

There are other options if you are no longer eligible for Medicaid.

If you are not able to receive Medicaid based on redeterminations, there may be other opportunities that would better suit you, such as Medicare, your state’s Healthcare Marketplace, or coverage from your employer.

After your Medicaid coverage has ended, you have six months to sign up for Medicare. You are able to choose Medicare coverage the month after Medicaid ends, or with a small lapse with no late enrollment penalties. This Marketplace option is only available until July 31, 2024. 

If you are not happy with the decision, you can appeal.

First and foremost, to avoid unjust disenrollment, make sure your contact information provided to your state’s Medicaid department is up to date and that you are opening and reading every communication sent to you. If you are handed a decision by the state that you do not believe is accurate, you are entitled to an appeal and a hearing to support your case. 

Supporting those who are going through this process will be important to ensure they are getting the correct outcome. If you did not receive the eligibility that you believe you were meant to, please reach out to us at McCarthy Law to see how we could assist.