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Medicaid Recipients Can Expect Eligibility Reviews this Year

Automatic Medicaid renewal – a pandemic-related policy – ends on March 31. As Florida transitions back to normal operations, all Medicaid recipients will be contacted for an eligibility review.

TALLAHASSEE, FLORIDA — Next month, Florida’s Department of Children and Families (DCF) will begin contacting all Florida Medicaid recipients to review eligibility requirements. Recipients will receive communication by mail and email with redetermination timeframes and next steps.

Florida’s economy has rebounded quickly and continues to outperform the nation in economic and labor market metrics. As a result, many families have had an increase in income and the ability to obtain insurance through employment.

PANDEMIC-RELATED CONTINUOUS COVERAGE

Throughout the pandemic, more than 1.7 million Floridians sought Medicaid assistance, bringing the total to 5.5 million in November 2022. But many are no longer eligible for the coverage due to new jobs, increased income, or other health insurance.

During the pandemic, to make sure there was continuous access to care, Medicaid recipients were automatically re-enrolled under a federal policy. In some cases, Florida is still paying toward healthcare plans for individuals who are not using any benefits because they have new coverage from a job or the healthcare marketplace.

GETTING BACK TO NORMAL OPERATIONS

As a result of legislative changes in the Consolidated Appropriations Act of 2023, the federal continuous coverage provision will end on March 31, 2023. DCF will transition back to business as usual and follow federal guidelines to restore Medicaid eligibility through standard processing procedures.

DCF has up to 12 months to complete Medicaid reviews once the continuous coverage period ends. During 2023, the Department will schedule and conduct redeterminations while minimizing the impact on families.

“The Department’s plan to return to the normal Medicaid eligibility processes is rooted in common sense,” Casey Penn, Assistant Secretary for Economic Self-Sufficiency with DCF, tells The Florida Standard.

“Every individual currently receiving Medicaid will go through the redetermination process, those that are eligible will continue to maintain their benefit and those that are not will be referred to alternative forms of health coverage,” Penn added.

WHAT TO EXPECT

Those affected should expect to receive letters about the recertification process starting in March. The letter will arrive in an envelope with a bright yellow stripe indicating that action is required.

“We urge all Medicaid recipients to login into their MyAccess account and verify that we have the most up-to-date contact information. When it's time to renew, we will contact individuals with all the information needed to complete the redetermination,” Penn tells The Florida Standard.

Eligibility depends on various factors, including household size, income, and the age of any children in the home. Visit the MyAccess portal to update contact information or create an online profile if you don't have one.

When individuals are determined ineligible for Medicaid, DCF will automatically transfer their application to Florida KidCare or federal programs to determine eligibility for low-cost or subsidized insurance through those programs.

Some individuals may fall into a Medicaid access gap. For example, if a family has income above the state's eligibility for Medicaid but below the federal poverty line, they won't be eligible for Medicaid or coverage from the Affordable Care Act marketplace.

Those who fall into the access gap may have to rely on federally qualified health centers, free clinics, and programs at public hospitals. These programs may operate on a sliding fee scale to ensure everyone receives care, regardless of their ability to pay.

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