What is Medicaid redetermination and what does it mean for your family?

Learn about Medicaid redetermination and how it may impact your family's coverage.
4 Minutes
 • 
Updated
Published
May 5, 2023

Due to the end of the public health emergency (PHE), Medicaid redetermination has resumed. If you and your family are currently covered by Medicaid, you might be wondering what this means for you. Understanding coverage can be stressful, but with the right resources, you can ensure proper coverage for yourself and your family.

This blog will discuss what Medicaid redetermination means, who it affects, and how you can prepare.

What you need to know

At the beginning of COVID-19, the federal government ensured families would not lose Medicaid coverage during the pandemic. The legislation paused Medicaid redetermination, typically a yearly event that determines whether those receiving Medicaid benefits are still eligible for coverage.

During the redetermination process, each state Medicaid agency reviews an individual's income, household size, and other eligibility criteria to ensure they still qualify for Medicaid coverage. If the state determines they no longer qualify for Medicaid, their coverage will be terminated.

  • Medicaid retermination means that states have begun their process of checking eligibility for Medicaid coverage.
  • You may no longer be eligible if you have had a pay increase or if you have not updated your personal information with your state.

Who’s impacted

There are three main reasons why people typically lose their Medicaid coverage:

  1. Income: their income has increased, and they now earn too much money to be eligible for Medicaid
  2. Age: they turned 65 and are now eligible for Medicare
  3. Lack of information: if the State does not have the information they need (for example, address and contact information)

If you fall into one of these categories, you will need to take action to continue coverage. The Centers for Medicare and Medicaid (CMS) is working with states to make sure to provide resources for families transitioning away from Medicaid. 

Visit www.healthcare.gov to see what health plans are available for your family. You can also call your state’s Medicaid office to confirm your coverage. 

Notices of redetermination

State Medicaid programs are required to send you notice of redetermination within 30 days to allow sufficient time for response. If you do not respond, the state must provide a 10-day notice before coverage is officially terminated.

Take action to ensure coverage.

To navigate the Medicaid redetermination process, families receiving Medicaid benefits should ensure their state Medicaid office has their correct contact information, including mailing address and phone number. If the Medicaid office requests additional information to verify eligibility, families should provide it as soon as possible and regularly check their email and mail for notices from the state Medicaid agency.

Completing the state's Redetermination Form for Medicaid online, which may require providing current address, household size, income, and information about other sources of health insurance, along with supporting documentation, is also essential. 

Families should periodically check their Medicaid redetermination status by logging in to their state Medicaid agency's website or by calling their state office. Families should also ensure that healthcare providers like Hazel Health have updated health coverage information. If your insurance coverage changes, please provide your updated information to Hazel Health by calling 800-764-2935. 

Resources: 

  • Healthcare.gov - A government website that provides information on health insurance and options for coverage.
  • Centers for Medicare and Medicaid Services (CMS) - The CMS is a federal agency that oversees Medicaid and provides assistance with the redetermination process. Their toll-free hotline, 1-800-633-4227 can offer support.
  • State Medicaid agencies - Each state has its own Medicaid program. Individuals can contact their state agency for support with the redetermination process. 
  • Local Medicaid offices - Some states have local Medicaid offices that offer in-person services. Check with your state’s Medicaid agency to find out if this is an option for you.

Medicaid redetermination can be stressful for families receiving Medicaid benefits, especially after the pause during COVID-19 Public Health Emergency. Families can ensure they maintain coverage and access healthcare resources by taking the proper steps. Stay informed and contact healthcare providers if you need assistance during this process. 

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About Hazel

Hazel Health, the leader in school-based telehealth, partners with school districts to provide mental and physical health services to K-12 students where they are–at school or home. Hazel’s diverse, culturally competent providers specialize in the health challenges of children and teens and partner with parents and school staff to make the best care decisions for students. Hazel is committed to improving health care equity and is available regardless of family income, geography, insurance status, or ability to pay. Hazel’s mission is to transform children’s access to health care, because when students feel better, they learn better.

Learn more at hazel.co.

About Hazel

Hazel Health, the leader in school-based telehealth, partners with school districts to provide mental and physical health services to K-12 students where they are–at school or home. Hazel's diverse, culturally competent providers work with parents and school staff to transform children's access to health care, because when students feel better, they learn better.

Learn more at hazel.co.

About Hazel

Hazel Health, the leader in school-based telehealth, partners with school districts to provide mental and physical health services to K-12 students where they are–at school or home. Hazel serves nearly 2 million students across 100 school districts, helping to reduce chronic absenteeism and unfinished learning by addressing gaps in health care access. As an extension of the school health team, Hazel helps schools immediately address student physical and mental health care needs. Hazel’s mission is to transform children’s access to health care because when students feel better, they learn better.

Learn more at Hazel.co/hazel-in-schools.

About Hazel

Hazel Health, the leader in school-based telehealth, partners with school districts to provide mental and physical health services to K-12 students where they are–at school or home. Hazel helps school districts address chronic absenteeism, unfinished learning, and school enrollment, by addressing gaps in health care access.

Learn more at Hazel.co/hazel-in-schools.

About Hazel

Hazel Health, the leader in school-based telehealth, partners with school districts and families to provide mental and physical health services to K-12 students where they are–at school or home. Instead of waiting for an appointment with a doctor or therapist, children can see a Hazel provider for a telehealth visit, at no cost to families. With guardian permission, Hazel’s telehealth platform allows children to connect with a health care provider within minutes, or a therapist within days of referral. Hazel’s providers can help with everything from allergies and stomach aches to anxiety and depression. With Hazel, children can get the care they need when they need it.

Learn more at Hazel.co/how-hazel-works.

About Hazel

Hazel Health, the leader in school-based telehealth, partners with school districts and families to provide mental and physical health services to K-12 students where they are–at school or home. At no cost, and regardless of insurance status, Hazel’s providers can help with everything from allergies and stomach aches to anxiety and depression. With Hazel, children can get the care they need when they need it.

Learn more at Hazel.co/how-hazel-works.

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