Redeterminations
Centers for Medicare & Medicaid Services requires beneficiary eligibility when Public Health Emergency (PHE) ends.
What your patients need to know.
As a healthcare professional, your patients look to you for expert advice. Be sure to remind them that they are required to verify their eligibility every year or they risk losing their Medicaid coverage. Also educate them on what other options might be available if they no longer qualify. See the details.
Let your patients know:
- They should receive a letter a few months before their Medicaid anniversary date with instructions for verifying their eligibility.
- It’s very important that they follow through on these instructions or they risk having their coverage cancelled.
- If their eligibility is confirmed, they can continue their existing coverage. If they are no longer eligible for Medicaid, they can explore our Marketplace (Ambetter from Buckeye) and Medicare (Wellcare By Allwell) options. Due to the American Rescue Plan Act of 2021, enhanced government subsidies are available and Marketplace coverage is even more affordable.
Impacts
- Nearly all 80 million people enrolled in Medicaid will have their eligibility redetermined, triggering a high risk of coverage losses:
- This risk can be mitigated through careful planning by CMS, states, health plans, providers, consumers and advocates;
- Patients can lose eligibility due to changes in age, household income, and other state-specific criteria; and
- Loss of coverage could make it harder for patients to get medical care and result in expensive medical bills.
- Patients who have moved, those with limited English proficiency (LEP), and people with disabilities, may be at greater risk for losing Medicaid coverage.
Fliers with details you can download and print, as needed.