The end of the COVID-19-related Medicaid continuous enrollment policy is projected to cause significant coverage losses in New York and nationally as states begin recertifying eligibility for Medicaid and the Medicare Savings Program (MSP).
Some current enrollees will no longer qualify, but those who do are also at risk; they must navigate burdensome administrative processes to stay enrolled, often with little guidance or support. Compliance may be especially difficult for some, including those the state cannot reach because they moved or changed their contact details. Others may be unaware they need to make a coverage decision or provide updated information, or they may have trouble submitting the necessary documents. Older adults and people with disabilities—in particular those who may have missed key Medicare or Medigap enrollment windows—could experience harmful coverage gaps and barriers.
Fred Riccardi, Medicare Rights Center’s president, says, “we support and applaud the steps CMS and New York State are taking to make coverage recertifications and transitions as painless as possible.” “We encourage a close look at measures that will enable older adults and people with disabilities to gain Medicare coverage seamlessly and stay enrolled in Medicaid.”
While state unwinding plans and timelines vary, New York will soon begin notifying consumers about these changes. All current Medicaid and MSP enrollees will receive important paperwork that they must complete and return by the stated due date to maintain coverage. The eligibility redeterminations in New York may happen fast for some beneficiaries. Medicaid and MSP cases with a June 30, 2023, end date will be closed effective July 1, 2023, if consumers do not recertify by completing the necessary renewal forms. Cases will continue to be renewed monthly, and New York must complete the unwinding process of eligibility redeterminations by the end of May 2024.
“It is important for consumers to check their health coverage and see what might change in the coming months,” said Mr. Riccardi. “If someone has Medicaid, they should contact their state agency to see what they need to do to recertify. Importantly, if they find out they no longer qualify, they might still be eligible for a Medicare Savings Program to help cover their Medicare costs. Those who still need to sign up for Medicare can use the new Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act Special Enrollment Period (SEP) to do so without penalty, and there is also an SEP for marketplace coverage for people losing Medicaid who are not eligible for Medicare.”
People with Medicare who have questions can call the Medicare Rights helpline at 800-333-4114.
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