The COVID-19 federal public health emergency gave generous incentives to state Medicaid agencies (AHCCCS) in exchange for not disenrolling people from Medicaid during the federal public health emergency.
The disenrollment suspension had been set to end when the PH emergency expires (now set for May 11, 2023) but the federal budget bill from last December directed states to begin their Medicaid redetermination on April 1, 2023, regardless of when the PH emergency ends, so redetermination will start in about 60 days.
AHCCCS thinks about 600,000 of the 2.5 million currently enrolled AHCCCS members may lose eligibility over the coming year once their year-long redetermination process is finished… and half of those that lose coverage could be for failing to respond to requests from AHCCCS for information to determine eligibility.
AHCCCS has a multi-pronged plan in place to make the redetermination process as smooth and accurate as possible… and to make sure as few people are disenrolled due to a lack of response as possible. Here are the basics of the plan:
AHCCCS will determine eligibility automatically for as many people as possible by coordinating with other federal and state data sources like social security and the Supplemental Nutrition Assistance Program. AHCCCS thinks they can do about 75% of eligibility determination work automatically, meaning members won’t need to do anything.
When members are successfully auto renewed, they’ll will get a summary letter saying: “If the information on the summary is correct, you do not need to do anything. You do not need to call or contact AHCCCS.”
If a member’s eligibility can’t be confirmed automatically, they’ll get a written request from AHCCCS that more information is needed. By rule, the person will need to reply within 30 days, which means having up-to-date contact information like addresses will be super-critical. AHCCCS plans to disenroll folks found to be ineligible before people that didn’t respond to their letter in time.
See AHCCCS’ “End of Continuous Enrollment Toolkit” with fliers, social, & a lot more for stakeholders to use to reach Medicaid audiences.
Note: by federal rule, AHCCCS can’t disenroll a member whose mail is returned undeliverable until making other good-faith attempts to contact the member.
Note 2: AHCCCS members who get kicked off because they’re not eligible anymore qualify for a special open enrollment with the federal marketplace. Marketplace and other sources for coverage options (see www.healthcare.gov).
What’s the Call to Action for AHCCCS Members Right Now?
Make sure AHCCCS has the correct mailing address, phone number, and email address for you! If you moved since March of 2020 – be proactive and make sure to update your contact information in www.healthearizonaplus.gov, or call Health-e-Arizona Plus at 1-855-HEA-PLUS (1-855-432-7587).
If AHCCCS determines that you no longer qualify for Medicaid, they’re supposed to tell you: 1) When your enrollment will end; 2) Information on how to appeal that decision if you believe the disenrollment was in error, and 3) Information about other health care coverage options available from Healthcare.gov.
More Information is Available in AHCCCS’ End of Continuous Enrollment Toolkit, at Preparing for the End of COVID-19: Return to Regular Renewals webpage, and this End of Continuous Enrollment Fact Sheet