GREENVILLE, S.C. (WSPA) – For those who use Medicaid, annual eligibility reviews are going to resume April 1.
Officials with the Department of Health and Human Services said the requirements for Medicaid are not changing, everything is just going back to the way it was before the pandemic.
Each state Medicaid agency is required to review their members’ eligibility each year. During COVID, a law was passed that called on states to pause this annual review process.
“We were in a period that was known as a period of continuous enrollment, where very few people were removed from the Medicaid program, even if they didn’t meet eligibility criteria,” said Jeff Leieritz.
Jeff Leieritz, with DHHS, said during this time people were only removed if they moved out of state, passed away or asked to be removed.
Since people were not being removed, enrollment increased.
“You have people that are enrolled in the program still who don’t meet the normal eligibility, or the regular eligibility requirements,” he said.
Congress passed a bill in December, that President Biden signed, which said the process would begin again on April 1.
“We have people who have remained in Medicaid who are likely no longer categorically eligible. They don’t meet the age or income requirements,” said Leieritz.
For people who do not qualify for Medicaid, there are resources available.
“We anticipate, through the end of 2023, that we will see some of these patients who had been previously on Medicaid, and who have been rolled off or not automatically re-enrolled,” said Suzie Foley.
Foley is with the Greenville Free Medical Clinic, a volunteer based, non-profit.
“Provides medical, dental, behavioral health, pharmacy services for low-income and uninsured Greenville County residents,” said Foley.
Their patients do not have Medicaid or Medicare.
“They really are those that fall through the cracks that don’t have access otherwise,” she said. “Low wage workers, particularly, those who are in positions who don’t offer any benefits through their workplace.”
Leieritz said most members will get a notice in the mail stating their annual eligibility date is coming up.
“If we’re able to identify that somebody is eligible and confirm that somebody is eligible with the information that we already have,” he said. “Or the information we have from another state agency, we will send somebody a continuation of benefits form.”
For anyone they can’t verify, they will receive an annual review form and will have 60 days to complete it.
These annual reviews will be spread out over a 12 month period. The first forms will go out in April, but not everyone will get them in the first few weeks.
DHHS said it’s very important all members have up-to-date contact information, to make sure yours is accurate, click here.
For more on the resources available, click here.