If you’re one of the millions of Americans receiving Medicaid benefits, you’re likely aware: big changes are on the horizon
That’s because the Medicaid continuous coverage provision of the Families First Coronavirus Act (CARES Act), established by our federal government to assist at-risk people during the COVID-19 pandemic, ended March 31, 2023. That means that redetermination of Medicaid eligibility will be required for all currently receiving Medicaid benefits.
Though the thought of losing Medicaid coverage may have you feeling at a loss—all is not lost.
Let’s talk about what you can expect and explore your options in affordable health care.
What does Medicaid redetermination mean?
Medicaid redetermination is the process that states, including Florida, use to ensure Medicaid enrollees meet requirements (such as income level) and are still eligible for Medicaid coverage.
States are required by law to periodically redetermine enrollees’ eligibility and disenroll those no longer meeting the eligibility guidelines.
What is happening to Medicaid?
The Medicaid program has a monthly redetermination process to determine eligibility. That process was put on hold during the pandemic, which meant many ineligible people continued to receive Medicaid benefits during the pandemic.
With the end of the pandemic, states like Florida are resuming the Medicaid redetermination process. Therefore, Medicaid recipients who were eligible at the beginning of the pandemic may now be determined ineligible and will lose their Medicaid coverage over the next year.
Why is Medicaid ending coverage for some enrollees?
The global pandemic had many far-reaching effects. Among them: massive Medicaid spending.
From the start, COVID-19 was considered a public health emergency (PHE), and Medicaid became even more of a priority. States began receiving significant increased federal funding to provide people with continuous Medicaid coverage.
In exchange for increased federal funding, states could not terminate Medicaid beneficiaries—even those technically no longer eligible for Medicaid assistance (for example, due to a change in income). This led to a massive uptick in Medicaid acceptance. Florida alone saw an increase in Medicaid assistance from 3.8 million enrolled in March 2020 to 5.5 million enrolled in November 2022.
Many ineligible people are still receiving Medicaid benefits. They haven’t been “disenrolled” even though they no longer qualify. In 2023, that is changing. Only those eligible may continue to receive benefits.
Medicaid cuts 2023? Back to business as usual.
In effect since March 2020, the continuous enrollment provision ended March 31, 2023. Since this provision’s expiration date took effect, states will return to normal (pre-pandemic) Medicaid renewal operations and eligibility assessments.
Redetermination of Medicaid eligibility will be required for all recipients. Millions are expected to lose Medicaid assistance as a result.
Who could lose Medicaid coverage due to redetermination?
Reasons for Medicaid cancellation could include:
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An increase in household income
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A change in household composition, such as no longer caring for a minor (i.e., a child under 18 who is not married/not emancipated)
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Failure to update contact information with your state Medicaid agency, Florida Department of Children and Families (Florida DCF), and therefore not having received important renewal notices
At greater risk for losing Medicaid coverage as continuous enrollment ends and Medicaid redetermination begins including those individuals who:
- have moved since the start of the pandemic, and therefore and may not have responded to requests(s) for eligibility information
- might have misinterpreted or overlooked a request for information simply because English is not their first language
- may be uninformed about recent policy changes due to a disability or serious medical challenge(s)
As states resume Medicaid redetermination and disenrollment as usual, you don’t want to risk losing Medicaid coverage in case you are still eligible. Be sure to check that your current contact information is on file with Florida DCF.
It’s also a good time to explore affordable health care options.
When might your Medicaid coverage be reviewed, renewed, or possibly end?
Medicaid renewals are managed by Florida DCF. They will schedule and conduct your Medicaid redetermination in line with federal regulatory requirements any time after March 31, 2023.
What happens when you lose Medicaid coverage?
If you’re no longer eligible for Medicaid coverage, Florida DCF will send you a notification by mail or email and through the MyACCESS portal.
Those determined not eligible for Medicaid but eligible for a different healthcare coverage program will automatically be referred to other agencies that might offer financial assistance. These may include Florida KidCare programs1, the Medically Needy Program2, and other subsidized federal programs. Check the MyACCESS portal to see if your application has been forwarded to one of these agencies.
You may also be referred to the Federal Marketplace (HealthCare.gov). There, you can shop health insurance plans and see if you qualify for premium tax credits and other health insurance savings.
Medicaid deadline 2023
Reviews for all Medicaid recipients throughout the entire state of Florida are due to be completed over a 12-month period.
- Many Medicaid recipients will benefit from automatic review and approval to continue Medicaid eligibility. In this case, you’ll receive a notice that your Medicaid renewal has been approved and your Medicaid coverage will continue.
- All Medicaid recipients will be notified (by mail or email, depending on your communications preference on file, and online through the Florida DCF MyACCESS portal) that it’s time to renew your application for Medicaid coverage.
So if you have not already received one, be on the lookout for a mailed or emailed notice from Florida DCF to complete your renewal. Upon receipt of that notice, you should renew and update any information as quickly as possible at https://www.myflorida.com/accessflorida.
The Florida DCF may ask for clarification from you while your case is being reviewed. Once all information is obtained, redetermination of Medicaid eligibility should be completed within 45 days. You can track the status of your application at the MyACESS portal.
To reduce the impact on families and create efficiencies for their workforce, Florida DCF will streamline the process as much as possible, for example, by combining reviews for both Medicaid and Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance to Needy Families (TANF).
What to do if you lose Medicaid coverage?
The best thing to do is start researching now. Check out public assistance programs (like Florida KidCare programs or the Medically Needy Program) as well health care plans offered by private insurance carriers—like Florida Blue.
We want to do everything we can to help. If you’re researching affordable health plans, look to a Florida Blue licensed agent to help you every step of the way. You might be pleasantly surprised how affordable health insurance can be…
65 or older?
Look to us to help you find just the right option in Medicare coverage.
Under 65?
We offer a range of plan options to suit your needs and budget.
Need help choosing a plan?
Our exclusive, appointed Florida Blue agents are happy to help you choose the best insurance plan for your unique needs.
At a time of uncertainty—and speculation that millions are poised to lose Medicaid benefits—knowing your options for finding affordable health care is more important than ever.
1Florida KidCare provides low-cost health coverage for children under age 18 to those who do not qualify for Medicaid.
2Medically Needy Program allows Medicaid coverage after a monthly “share of cost” is met. Those who are not eligible for “full” Medicaid because of income or asset limits may qualify.
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