An estimated 350,000 people will lose Medicaid coverage as Virginia resumes eligibility review
Regional and state health organizations are encouraging those on Medicaid to update their contact information to ensure they are still eligible for coverage as the state reviews the program’s rolls for the first time in three years.
The annual review was paused during the pandemic.
“It’s not something new and onerous that is being put on people,” said Sara Cariano, senior health policy analyst at the Virginia Poverty Law Center.
State departments and health organizations are holding meetings to coordinate with each other to reduce any potential disruption and ensure those who are no longer eligible either already have coverage or can obtain some kind of care, according to state and health group representatives.
“A lot of times when someone is in a situation where they haven’t gotten the notice, they find out either at the doctor or the pharmacy that they’re no longer covered, which is about the worst time to figure it out,” Cariano said.
Virginia Medicaid rolls increased by over 40% to more than 2 million members from 1.5 million in January 2020, according to state data.
Now, the Virginia Department of Medical Assistance Services estimates roughly 351,000 will no longer be eligible, according to DMAS leaders.
The federal agency Centers for Medicare and Medicaid Services is allowing states between nine and 14 months to go through the redetermination process, according to Sarah Hatton at the state department.
“We will be rolling these renewals out over a 12-month period, which we planned this in order to have months 13 and 14 that CMS is allocating to do any additional cleanup work that may be needed,” she said.
Individuals are asked to complete and return their eligibility packets within 30 days. The state agency is mailing packets out two months before they are due, according to Hatton. For example, the first set of packets due in May were mailed out at the end of March, she said.
“We do this to make sure individuals have enough time to return their packets and then once the packets are returned, if there are any additional verifications needed, it gives time for that back and forth period of requests for any additional verifications,” Hatton said.
She said even if current Medicaid members don’t think they are still eligible, they should fill out and return the packets because DMAS could still help refer them to other subsidized coverage.
On April 3, DMAS opened a new call center to aid in the process, according to Hatton. The state agency also is providing grants to the Virginia Health Care Foundation for Project Connect for outreach and enrollment in areas with the highest number of uninsured people, according to the VHCF website.
Clinics such as the Western Tidewater Free Clinic in Suffolk are reminding patients to make sure their contact information is up to date, said Ashley Greene, executive director.
“Because they will be communicated with when they are being redetermined and when they need to re-enroll,” she said.
Rufus Phillips, Virginia Association of Free and Charitable Clinics CEO, said clinics and local Department of Social Services offices recognized early the importance of their relationship as they had planned for the resumption of the eligibility process.
Those relationships between the groups is important so those who come into clinics have been unknowingly unenrolled are able to get the help they need.
The six health plans that contract with Medicaid also are reminding people to make sure their contact information is up to date and help with the eligibility documents, according to Doug Gray, executive director of the Virginia Association of Health Plans.
The emphasis on the process is also important for many who may have never gone through the redetermination process. Virginia expanded Medicaid coverage in 2019 and the public health emergency began in early 2020.
“We’re just in the beginning weeks so pretty soon, we’re going to find out that there are a number of people who are not responding and the first sets of lists will start to be shared of people who are either not eligible because they didn’t respond or people who are not eligible because they’ve been determined not to be eligible,” Gray said.
He said techniques to make sure those who may not be replying have some other source of coverage or care can be done by checking other state Medicaid rolls, tax records, providers and plans.
“They’ll be a number of ways we’ll find out,” Gray said. “We’re hoping to do it in a more proactive way so that we find out sooner.”
Ways for Medicaid recipients to update contact information for eligibility process
Additional online resources
https://www.vda.virginia.gov/vicap.htm
Virginia Health Care Foundation
Hampton Roads area social service organizations
Ian Munro, 757-447-4097, ian.munro@virginiamedia.com
