Helping members navigate Medicaid redeterminations

As of April 1, 2023, states have begun Medicaid and CHIP eligibility redeterminations. The process involves verifying a person’s income, level of care, and other factors to determine if the person still qualifies for Medicaid or CHIP services. Some people, including dually eligible and/or individuals living with disabilities, could be disenrolled from those programs if they do not take the necessary steps to verify Medicaid eligibility. To help support consumers through this process, UnitedHealthcare has worked in collaboration with the National Association for Home Care & Hospice (NAHC) to create a new redeterminations FAQ sheet. This educational resource is developed for in-home care providers to help consumers be informed, aware, and proactive throughout the redetermination process.

What are Medicaid redeterminations?

At the start of the COVID-19 pandemic, Congress enacted an important provision allowing continuous Medicaid eligibility throughout the public health emergency (PHE).  Continuous eligibility allowed people to remain enrolled in their Medicaid program without requiring periodic verification of eligibility for the program. Anyone who was already enrolled on Medicaid as of March 2020 or who successfully enrolled between 2020-2022 could not be removed from the program. From February 2020-March 2023, Medicaid enrollments grew by 23.3 million people.1

Due to recent Congressional action, states are able to resume Medicaid eligibility determinations and disenrollments as of April 1, 2023. States are in various stages of planning for how and when beneficiary redeterminations will occur. Under guidance from the Centers for Medicare & Medicaid Services (CMS), states have 12 months to begin redeterminations for each individual and 14 months to complete the process, meaning states must have initiated every redetermination by March 31, 2024 and must complete the process for all enrolled individuals by May 31, 2024.

New educational resource for in-home providers

Individuals who do not complete their state’s Medicaid eligibility requirements by the appropriate deadline may be disenrolled from the program. Many may be unaware that redeterminations are happening, especially after over three years has passed since the last time renewals were required. They may also be confused by the paperwork the state sends or may not have received it due to a change of address or other circumstance.

This FAQ sheet provides timely information about Medicaid redeterminations and the steps necessary for consumers to maintain coverage, find new coverage, or access the services they need.

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