Florida to begin Medicaid eligibility redeterminations in April
When the federal public health emergency (PHE) was put in place at the start of the COVID-19 pandemic, Florida received additional funding from the federal government under the condition that the state provides continuous Medicaid coverage and does not disenroll beneficiaries. The Consolidated Appropriations Act of 2023 ends the continuous coverage provision on March 31st, and delinks it from the PHE.
Florida saw a significant increase in the number of individuals and families on Medicaid. In March 2020, there were 3.8 million enrollees, while in November 2022, there were 5.5 million enrollees, according to the Department of Children and Families (DCF).
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DCF determines Medicaid eligibility in Florida, and the Social Security Administration determines Medicaid eligibility for SSI recipients. DCF will follow federal guidance to determine Medicaid eligibility, such as CMS allowing state agencies up to 12 months to complete Medicaid reviews after the continuous coverage period ends. Over the next 12 months, DCF will work to notify and communicate with all current Medicaid beneficiaries about their redetermination timeframes and the process for next steps.
While the economic and labor market in Florida continues to grow, many families have seen an increase in income and the ability to obtain employer-sponsored insurance, according to DCF.
Many beneficiaries will undergo an automatic review process and approval to continue Medicaid coverage. In this case, beneficiaries will receive a notice about their updated Medicaid status. Once DCF obtains all information needed to redetermine Medicaid eligibility, it will make a decision regarding eligibility within 45 days.
Beneficiaries who are no longer eligible will begin to lose coverage in May. Florida’s redetermination approach is population-based, and prioritizes those who are aging out, or are becoming categorically ineligible.
If DCF can’t automatically determine Medicaid eligibility because additional information is required, the department will send a notice with instructions on how to complete the renewal process 45 days before the renewal date. Once this notice is received, DCF states that it is crucial to act timely to provide additional information to ensure there is no disruption in coverage.
DCF recommends that beneficiaries ensure their address on file is updated. It also recommends that beneficiaries be alert for an email or physically mailed notice from the department to complete the renewal process. DCF may ask beneficiaries for additional information while they are undergoing redeterminations.
A recent survey published by the Robert Wood Johnson Foundation and conducted by Urban Institute found that 64.3% of Medicaid beneficiaries who were surveyed across the country were not aware of the renewal process, while only 16% of Medicaid beneficiaries surveyed were merely a little aware of eligibility redeterminations. The survey also found that 13.9% of Medicaid beneficiaries surveyed were somewhat aware of Medicaid eligibility redeterminations, while 5.1% surveyed were very aware.
A notification from DCF will be sent through MyAccess accounts, as well as a physical letter or email, for individuals who are deemed no longer eligible for Medicaid. Individuals deemed ineligible for Medicaid will be automatically referred to additional healthcare coverage programs, if eligible.
Available programs include Florida KidCare, which provides low-cost healthcare coverage for children and is based on family income, and the Medically Needy Program, which allows Medicaid coverage after a monthly share of cost is met. Individuals can check their MyAccess account to see if their application has been forwarded to either of those agencies.
For individuals who are ineligible for Medicaid following the redeterminations process, they can access the Federally Qualified Health Centers webpage to locate healthcare coverage in their area. For guidance navigating the healthcare system, individuals can contact a list of healthcare navigators.
Individuals who are not eligible for Medicaid may receive assistance with the cost of prescription medications through Florida RX or the Florida Discount Drug Card Program.