Unwinding Medicaid Eligibility Means Making Sure Patients Have The Right Coverage
This article first appeared as a column in the May issue of South Florida Hospital News
By Mary Mayhew, FHA President and CEO
During the COVID-19 PHE, the number of Floridians qualifying for Medicaid coverage increased from 3.8 million in March 2020 to 5.7 million in January 2023. With the end of continuous eligibility, on April 1, the Department of Children and Families started disenrolling individuals who are no longer eligible for coverage due to income changes that happened between 2020 and 2023. An estimated one million enrollees may be new to the redetermination process, having not experienced one before.
For the first time in three years, the state has begun redetermining eligibility for Medicaid enrollees, as is required by federal law with the end of the federal public health emergency. To avoid disruption to ongoing care that could result from Medicaid redeterminations, hospitals are working with state agency partners and community-based organizations to ensure that all individuals are aware of Medicaid eligibility redeterminations and understand other options for coverage if continued Medicaid enrollment is not possible.
To manage the redetermination process, the Department of Children and Families is prioritizing redeterminations for individuals who are no longer eligible based on information on file from their last redetermination date. The second priority is redeterminations for enrollees who have not used their Medicaid benefit in the last 12 months. The remaining enrollees will be reviewed on their next regularly scheduled renewal date except when DCF can align the renewal date, when possible, to coincide with the date of other members within the household/family unit, or their renewal date for SNAP or TANF benefits. Vulnerable populations such as children with complex medical needs will be last in the review/redetermination schedule.
Consistent health care coverage is critical for timely access to preventive, primary, specialty, and behavioral health care and for treatment plan adherence. And it helps to lower the expense of charity care incurred by hospitals. Florida hospitals are committed to their role as not just health care providers but as patient advocates and are encouraging all Medicaid enrollees to be aware of the redetermination process by:
Updating Their Contact Information: Make sure DCF has the enrollee’s current mailing address, phone number, email, or other contact information. This way, they will be able to contact the individual about their Medicaid coverage.
Checking the Mail for an Envelope with a Yellow Stripe: DCF will mail individuals a specially marked letter about their Medicaid coverage. This letter will also let them know if they need to complete a renewal form to see if they still qualify for Medicaid.
Completing the Renewal Form: Individuals receiving a renewal form should complete and return it to DCF as quickly as possible to help avoid a lapse in Medicaid coverage.
These resources and more are available online at fha.org.
Florida’s hospitals are also working with patients to identify alternatives to Medicaid coverage, such as Florida KidCare or the federal health insurance marketplace, and providing enrollment assistance.
Florida’s hospitals are extremely concerned about individuals losing health care coverage and subsequently losing timely access to care. As such, hospitals are committed to helping individuals secure reliable coverage. For Florida’s hospitals, care means not just providing medical and behavioral health treatment, but also improving the health status of their communities.