AAAs - Medicaid unwinding and redeterminations Information - ACL

Thank you for your assistance that your agency has done to help individuals not to lose their Medicaid benefits. The Administration for Community Living (ACL) has contacted the Department regarding Medicaid redeterminations and

Medicaid Changes 2023 (1)

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based on data from 41 states and the District of Columbia, KFF reports that nationally almost 3.8 million people have been disenrolled from Medicaid as of August 1, 2023. Many of these individuals may still be eligible for Medicaid, but lost coverage because they didn’t return forms, or they or the state made other errors.

Please continue and look for ways to communicate with individuals who are being redetermined, for example, using newsletters, attaching flyers to packaged home-delivered meals, distribute at training events, add to information and referral activities, share on social media, post on bulletin boards, through senior community centers, etc. Include the name of Pennsylvania’s Medicaid program (Community Health Choices, LIFE Program) and ACA Marketplace (Pennie). Some individuals may not realize they have Medicaid coverage if it goes by another name, and they may not realize that they need to look for renewal information. A federal link for Medicaid information is Medicaid online. To help and inform individuals who have lost Medicaid coverage, please continue to utilize your PA Link (1-800-753-8827) Person-Centered Counselors within your agency that will help with completing applications and navigating individuals through this process. Continue to use aging network available services and supports such as PACE Program, MEDI, OPTIONS, Caregiver Support Program, Long-Term Care Ombudsman, etc. For more information, please refer to the enclosed attachment - Important Information for Older Adults with Medicaid – Complete your Annual Renewal to Stay Covered.

ACL and the Commonwealth is seeking support to make sure individuals don’t lose their Medicaid benefits. At the beginning of the COVID-19 pandemic, significant, but temporary, changes were made to Medicaid enrollment and eligibility rules to prevent people from losing Medicaid coverage during the pandemic. With the end of the federal Public Health Emergency on May 11, 2023, states are resuming their regular processes for renewing individuals’ Medicaid coverage. Individuals are to be informed that they may need to take action/ appeal to remain covered and that there are steps they can take if they lose Medicaid.

It is important to make sure everyone covered by Medicaid knows:

Over the next 12 months, everyone with health care coverage through Medicaid or the Children’s Health Insurance Program (CHIP) will need to renew their coverage.
What needs to be done to avoid losing coverage if they are still eligible.
Other options for coverage if they are no longer eligible for Medicaid or CHIP (such as the Affordable Care Act (ACA) Marketplace or employer-sponsored coverage), and how to find help navigating them.
Programs that can help if they want to appeal the loss of Medicaid coverage.

Every Medicaid beneficiary needs to receive these important messages:

UPDATE your contact information with your state Medicaid agency NOW.
RESPOND to the Medicaid renewal form when it comes in the mail. If you don't, you may lose your coverage even if you are still eligible.
PARENTS should respond even if you are not eligible or are enrolled in other coverage. Your children could still be eligible for coverage.
CONNECT WITH RESOURCES THAT CAN HELP: If you lose Medicaid coverage and think you may still be eligible, there are programs that may be able to help you appeal the denial of Medicaid coverage or find other insurance.

State protection and advocacy systems and legal advocacy organizations funded under the Older Americans Act may be able to help with appeals.
Disabled people of all ages can contact the Disability Information and Access Line (DIAL) for assistance.
Older adults can contact the Eldercare Locator to find local assistance.
Older adults and people with disabilities who are eligible for Medicare can also find assistance through their State Health Insurance Assistance Program (SHIP). SHIP is a national program that offers one-on-one assistance, counseling, and education to Medicare beneficiaries of all ages, their families, and caregivers to help them make informed decisions about their care and benefits.
Benefit Enrollment Centers can also help connect people with insurance or other benefits.

CHECK OTHER OPTIONS: If individual is no longer eligible for Medicaid, check to see if they can get coverage through their employer or through the Affordable Care Act Marketplace at www.healthcare.gov.

ACL’s networks are a part of the communities that you serve, and your community connectio

ns can make a huge difference in this effort. Please work with your community networks and other groups who can help -- not only with getting the word out about redeterminations but also with finding creative ways to protect Medicaid eligibility and assisting people who may no longer be eligible for Medicaid in getting other health coverage. The Centers for Medicare & Medicaid Services (CMS) has developed a variety of materials that you can use to ensure your communities and networks have this important information. For example, their Communications Toolkit — available in English, Spanish, Chinese, Hindi, Korean, Tagalog, and Vietnamese — contains important messages and sample materials (like drop-in articles, social media messages, and flyers) for states and other partners to use. CMS has also created fact sheets, including one with suggestions for things you can do to help keep people covered. You are encouraged to work with the state Medicaid agency to ensure that the process of renewing Medicaid eligibility goes smoothly for older adults and individuals with disabilities. CMS will be hosting a series of Medicaid and Children’s Health Insurance Program (CHIP) Renewals webinars focused on special populations, including one focused on reaching aging and disabil

ity populations on Thursday, August 17 from 3-4pm ET. This webinar series will provide partners with strategies to reach out to diverse communities and audiences to share information about Medicaid and CHIP renewals. Each webinar will also include a “train-the-trainer” presentation, during which CMS will walk-through a set of downloadable slides that partners can use to educate others in their communities about Medicaid and CHIP renewals. Registration is required.

For additional information and the latest resources, visit the "unwinding" page on ACL.gov. Your commitment and ability to assist in this effort is appreciated. Best regards, Steven