The Public Health Emergency (PHE), declared by the U.S. Department of Health and Human Services (HHS), has significantly impacted healthcare access across the nation, including Medicaid eligibility in Florida. For Florida residents relying on Medicaid, it’s crucial to understand the upcoming changes as the continuous coverage provision, enacted during the PHE, is coming to an end. This guide, provided by a content expert at hudsonfamily.net, will clarify what this means for you and how the Florida Department of Children and Families (fl dept of children’s and families) is managing this transition to ensure continued healthcare access for eligible individuals and families.
What is the Public Health Emergency and its Impact on Florida Medicaid?
A Public Health Emergency is a formal declaration by the HHS when a disease outbreak or public health threat occurs. During the COVID-19 pandemic, a PHE was declared on January 31, 2020. To ensure people retained healthcare coverage during this critical time, the Families First Coronavirus Response Act mandated that states maintain continuous Medicaid coverage for enrollees throughout the PHE. In Florida, this meant that individuals remained on Medicaid, even if their circumstances changed, thanks to the fl dept of children’s and families adherence to these federal guidelines.
However, with the Consolidated Appropriations Act, 2023, this continuous coverage is set to expire.
When Does Continuous Medicaid Coverage End in Florida?
The continuous coverage provision for Medicaid in Florida officially ended on March 31, 2023. This date marks a significant shift in Medicaid enrollment processes.
What Happens Now That Continuous Coverage Has Ended?
Following the end of continuous coverage, the fl dept of children’s and families has initiated a redetermination process over 12 months to review all Florida Medicaid cases. This review is to ensure that current recipients still meet the eligibility requirements for Medicaid benefits.
Automatic Medicaid Renewal in Florida
Many Medicaid recipients in Florida will benefit from an automatic review and approval, known as passive or ex parte renewal. In these cases, the fl dept of children’s and families can verify ongoing eligibility without requiring additional action from the recipient. If your case is automatically renewed, you will receive an official notice confirming the continuation of your Medicaid coverage.
What if the Florida Department of Children and Families Needs More Information?
If the fl dept of children’s and families cannot automatically verify your eligibility, they will send you a notice approximately 45 days before your renewal date. This notice will include clear instructions on how to complete the renewal process and provide any necessary updated information. It is vital to respond to this notice promptly and provide the requested information to avoid any potential disruption in your Medicaid coverage.
To stay informed and receive timely updates, the fl dept of children’s and families encourages recipients to sign up for email notifications through the MyACCESS account. You can learn more and sign up for paperless notifications here: Going Paperless: Email Notifications and Online Notices.
For assistance with your MyACCESS account or updating contact information, the fl dept of children’s and families provides helpful ‘How To’ videos on the Access Florida website: Access Florida – Florida Department of Children and Families.
Actions to Take Now That Continuous Coverage is Over
To ensure a smooth Medicaid redetermination process, take these immediate steps:
- Update Your Address: Log in to your MyACCESS account at https://myaccess.myflfamilies.com and verify that your address and contact information are current. This ensures you receive important notices from the fl dept of children’s and families.
- Watch for Notices: Be vigilant for mailed or emailed notices from the fl dept of children’s and families regarding your Medicaid renewal.
- Renew Promptly: Upon receiving a renewal notice, complete the process as quickly as possible through your MyACCESS account. Provide all requested information accurately and promptly.
What Happens if You Are No Longer Medicaid Eligible?
If, after the redetermination process, the fl dept of children’s and families finds you no longer eligible for Florida Medicaid, you will receive an official notification through your MyACCESS account, as well as by mail or email. However, losing Medicaid coverage doesn’t mean losing access to healthcare.
The fl dept of children’s and families will automatically refer individuals who are ineligible for Medicaid but may qualify for other healthcare coverage programs. These referrals include:
- Florida KidCare: This program offers low-cost health insurance for children based on family income. Learn more at: www.floridakidcare.org.
- Medically Needy Program: This Florida Medicaid program provides coverage for individuals who meet certain medical expense criteria. More information is available in the Medically Needy Brochure.
- Federal Marketplace: Your application may be transferred to the Federal Health Insurance Marketplace. You will receive instructions from the U.S. Department of Health and Human Services on how to apply. Visit www.healthcare.gov for more details.
You can always check your MyACCESS account to see if your application has been forwarded to any of these agencies.
Documentation for Medicaid Redetermination
The fl dept of children’s and families may require updated documentation to complete your Medicaid redetermination. While you have previously verified some eligibility factors, you may need to provide current information on:
- Household members
- Income
- Asset information (for certain coverage types)
Medicaid Redetermination Review Timeframe
Once the fl dept of children’s and families has all necessary information, they will typically make an eligibility decision within 45 days. If you are found ineligible for Medicaid, your application will be automatically forwarded to Florida KidCare, the Medically Needy Program, and other federal healthcare programs as mentioned earlier. Again, you can track the status of your application referrals through your MyACCESS account.
Additional Healthcare Resources Beyond Medicaid
For individuals who do not qualify for Medicaid, there are other avenues for healthcare assistance in Florida. These include community health centers and various programs to help with prescription drug costs. These programs are not managed by the fl dept of children’s and families, but are valuable resources.
To navigate the healthcare system, consider contacting a Healthcare Navigator. A list of Florida-registered and federally-certified Navigators is available at My Florida CFO. You can also find a Health Insurance and HMO Overview guide at My Florida CFO.
What if You Disagree with a Medicaid Ineligibility Decision?
If the fl dept of children’s and families determines you are ineligible for Medicaid and you believe this decision is incorrect, you have the right to appeal. You should initiate an appeal within 10 days of the date on your denial letter by contacting the Office of Inspector General (OIG). Importantly, you can choose to retain your Medicaid coverage while your appeal is being processed.
Understanding these changes and acting proactively will help ensure you and your family maintain access to necessary healthcare services during this transition from continuous Medicaid coverage in Florida, managed by the fl dept of children’s and families.
