The Public Health Emergency (PHE), declared in response to significant health crises, has had a notable impact on healthcare coverage, particularly for families relying on Medicaid. For many families with children, Medicaid provides crucial access to healthcare services. It’s important for families to understand how the end of the federal PHE affects their Medicaid eligibility and what steps they need to take to ensure continuous healthcare coverage for themselves and their children. This guide explains the key changes and provides actionable steps for Florida families to navigate this transition.
What is a Public Health Emergency and How Does It Affect My Family’s Medicaid?
A Public Health Emergency (PHE) is officially declared by the U.S. Department of Health and Human Services (HHS) when a disease or public health threat arises. This declaration allows for specific measures to be taken to address the emergency. During the COVID-19 pandemic, a PHE was declared on January 31, 2020, which had significant implications for Medicaid recipients nationwide.
One key provision during the PHE, under the Families First Coronavirus Response Act, was the requirement for states to maintain continuous Medicaid coverage for enrollees. This meant that in Florida, even if a family’s circumstances changed – such as income or household size – they generally remained enrolled in Medicaid. This continuous coverage was a vital safety net for many families with children, ensuring they didn’t lose healthcare access during uncertain times.
However, federal legislative changes in the Consolidated Appropriations Act, 2023, have brought this continuous coverage to an end. The provision expired on March 31, 2023, marking a significant shift for Medicaid recipients and families across Florida. Understanding this change is the first step for families to protect their healthcare coverage.
When Does Continuous Medicaid Coverage End and What Does This Mean for My Children?
The continuous Medicaid coverage provision officially ended on March 31, 2023. This date is critical for Florida families to remember because it signifies the start of the redetermination process for Medicaid eligibility. For families with children currently enrolled in Medicaid, this means their eligibility will now be reviewed to determine if they still qualify under the standard Medicaid rules.
The end of continuous coverage doesn’t automatically mean families will lose Medicaid. Instead, it initiates a process where the Florida Department of Children and Families will reassess each Medicaid case over the following 12 months. This review is to ensure that everyone currently receiving Medicaid benefits still meets the eligibility criteria. It’s crucial for families to understand that action may be required on their part to maintain their coverage.
What Happens After Continuous Coverage Ends? Will My Family Automatically Lose Medicaid?
No, families will not automatically lose Medicaid immediately after March 31, 2023. The Florida Department of Children and Families is conducting a phased redetermination process over 12 months. Many families will experience what is called an automatic review or passive renewal.
In an automatic review, the Department will use existing data to verify ongoing eligibility. If they can confirm a family’s eligibility without needing additional information, they will send a notice of approval, and Medicaid coverage will continue uninterrupted. This is designed to streamline the process and ensure continued coverage for eligible families without requiring them to take any action.
However, if the Department needs more information to verify eligibility, they will send a renewal notice approximately 45 days before the family’s renewal date. This notice will include instructions on how to complete the renewal process and provide the necessary updated information. It is vital for families to be vigilant and promptly respond to these notices to avoid any potential gaps in their Medicaid coverage. For families with children, maintaining continuous healthcare coverage is paramount for their well-being and access to necessary medical care.
To stay informed and receive important updates, families are encouraged to sign up for email notifications through the Going Paperless: Email Notifications and Online Notices service. Additionally, resources like the ‘How To’ videos available at Access Florida – Florida Department of Children and Families can help families manage their MyACCESS accounts and update contact information.
What Steps Should My Family Take Now to Ensure Continuous Medicaid Coverage?
The most important initial step for families is to ensure their contact information is up-to-date with the Florida Department of Children and Families. This is primarily done through their MyACCESS account online. Accurate address, phone number, and email address are crucial to receive important notices and updates regarding Medicaid redetermination.
Families should actively monitor their mail and email for any notices from the Department. If a renewal notice is received, it’s imperative to act quickly and follow the instructions provided to complete the renewal process. This may involve updating information about household members, income, and other relevant details. Promptly providing any requested information will help the Department efficiently review the case and minimize the risk of coverage disruption.
The primary portal for managing Medicaid information and completing renewals is the https://myaccess.myflfamilies.com website. Families should familiarize themselves with this platform and use it to update their information and respond to any requests from the Department.
What If My Family Is No Longer Eligible for Medicaid? Are There Other Options for My Children’s Healthcare?
If, after the redetermination process, it’s found that a family is no longer eligible for Medicaid, the Department will send a notification through their MyACCESS account, as well as via mail or email. However, losing Medicaid doesn’t necessarily mean losing all access to healthcare coverage.
Florida has several programs designed to provide healthcare options for families and children. Importantly, if a family is deemed ineligible for Medicaid but might qualify for other healthcare programs, their application will be automatically referred to programs like Florida KidCare, the Medically Needy Program, and other federally subsidized healthcare programs.
Florida KidCare is specifically designed to provide low-cost health coverage for children based on family income. More information about this program can be found at www.floridakidcare.org. The Medically Needy Program offers Medicaid coverage to individuals and families who meet certain medical expense criteria, even if their income is slightly higher. Details are available in the Medically Needy Brochure.
In some cases, applications may be transferred to the Federal Marketplace. Families will receive a letter from the U.S. Department of Health and Human Services with instructions on applying for healthcare insurance through the Marketplace. Information about the Federal Marketplace can be found at www.healthcare.gov.
What Kind of Information Might the Department Need for Medicaid Redetermination?
To complete the Medicaid redetermination, the Department may require updated information and documentation. While some eligibility factors like identity, Florida residency, and citizenship were likely verified during initial enrollment, families may need to provide current details on:
- Household Members: Any changes in the number of people living in the household.
- Income: Updated income information for all household members.
- Assets: For certain Medicaid coverage types, asset information may be required.
The specific documentation needed will be outlined in the renewal notice if additional information is required. Families should gather these documents promptly to facilitate the review process.
How Long Will the Medicaid Redetermination Process Take?
Once the Department has all the necessary information for a case, they aim to make an eligibility decision within 45 days. The review process involves determining both general Medicaid eligibility and the appropriate level of coverage.
If a family is found ineligible for Medicaid, their application will be automatically referred to Florida KidCare, the Medically Needy Program, and other relevant programs. Families can track the status of their application and any referrals through their MyACCESS account.
Where Can My Family Find Other Medical Help If We Are Not Eligible for Medicaid?
For families who are not eligible for Medicaid or while exploring other coverage options, several resources can provide healthcare assistance:
- Federally Qualified Health Centers (FQHCs): These centers offer primary care services on a sliding fee scale, making healthcare affordable for individuals and families without health insurance.
- Prescription Assistance Programs: Various programs can help with the cost of prescription drugs for those who qualify.
It’s important to note that these programs are separate from the Department of Children and Families and are provided as potential resources. Healthcare Navigators can offer guidance in navigating the healthcare system. A contact list of Florida-registered and federally-certified Navigators is available through My Florida CFO. Additionally, a guide on Health Insurance and HMO Overview is available at My Florida CFO.
What If My Family Disagrees with the Medicaid Ineligibility Decision?
Families have the right to appeal if they believe a Medicaid ineligibility decision is incorrect. An appeal should be initiated within 10 days of the date on the denial letter by contacting the Office of Inspector General (OIG). During the appeal process, families have the option to retain their Medicaid coverage, ensuring continued access to healthcare while the appeal is being reviewed.
Understanding the changes to Medicaid and taking proactive steps is crucial for Florida families to ensure they and their children maintain continuous healthcare coverage. By staying informed and acting promptly, families can navigate this transition smoothly and access the healthcare resources they need.
