As you are undoubtedly aware, early in the pandemic, the federal government declared a public health emergency (PHE) and passed laws that provided increased Medicaid funding to states, in return for which they were prohibited from disenrolling people off their Medicaid rolls. Late last year, the federal government separated the continuous Medicaid enrollment from the PHE and established a schedule of "unwinding," or resuming eligibility redeterminations beginning April 1. This means that there is a possibility that people currently on Medicaid waivers could lose their Medicaid eligibility on their next anniversary.
What can residential providers do? You can help the people you support in your programs make sure that their contact information on file at DHS is correct, to ensure that their enrollment materials will reach them when the time comes. You can also help them access information on what the renewal process looks like. DHS has set up a website for renewal of coverage that contains this information and more, and you can help people navigate it to learn more.
There is also important information regarding Medicare enrollment to be aware of. People who became eligible for Medicare during the pandemic may have decided not to enroll, thinking they did not need it because they were covered by Medicaid. Now they may be outside a Medicare enrollment. However, many will be eligible for a Special Enrollment Period (SEP) based on the termination of their Medicaid. This SEP will allow them to enroll in Medicare and have coverage begin either the next month or retroactive to the month Medicaid coverage ends.
In addition, some people with both Medicare and Medicaid may lose Medicaid and thus no longer be eligible for a Medicare Advantage plan, if they were on one. Individuals in this situation will need special counseling, including information on Medicare enrollment periods, penalties, and Medicare Advantage plan options. State Health Insurance and Assistance Programs (SHIPs) provide people eligible for Medicare with information and counseling about their health insurance options and can help people navigate these issues.
The federal Administration for Community Living (ACL) has some great information, including a recent blog post with links to other resources. I encourage you to check it out.
-Ken Bence, Director of Research, Analysis and Policy