Medicaid changes coming in May

For the first time in three years, Virginia residents on the state’s Medicaid programs will have to verify their income beginning later this month. Federal rules require states to periodically verify the incomes of people on Medicaid and remove them if their income exceeds the program limits. Those income checks were suspended during the pandemic, but now, as things get back to normal, the old rules are being put back in place.

In December 2022, Congress set a timeline to wind down COVID-19 emergency measures. That included the Consolidated Appropriations Act, which put an end to the continuous coverage. For most states, the change happened April 1. In Virginia, however, the Assembly determined that changes in coverage won’t take effect until April 30.

“It is important that all Medicaid members are aware of the renewal process, because every member will undergo a renewal over the next 12 months,” said Rebecca Dooley, spokesperson for the Virginia Department of Medical Assistance Services (VDMAS).

At the same time, she says there’s no need to panic.

“If we are able to verify all information needed to renew eligibility using existing data and other data sources, the member will be renewed automatically and will receive a notice of re-enrollment letter rather than a renewal form,” Dooley said. “Otherwise, members will receive a renewal form in the mail, and it’s imperative they respond so their renewal can be processed.”

So to be clear, if the existing data on file can verify a Medicaid recipient’s income, they’ll get renewed. If not, they’ll get a form in the mail and will have to provide the needed documents.

HOW LONG WILL THE PROCESS TAKE?

And don’t get concerned if you haven’t heard from Medicaid within a few days or weeks. As the VDMAS staff point out, this will not be a quick transition. Dooley says that nobody’s Medicaid coverage will be canceled or reduced, even if there are questions, until the updated information is processed. As mentioned above, all information will be sent through the mail and members will be sent a checklist to fill out and return, if there are questions.

The state gives 12 months to complete these changes, so some members may not hear right away about how this change affects them. In the meantime, members are encouraged to make sure all information, especially address and phone number, are up to date to receive information as timely as possible.

A member can call Cover Virginia at 1-855-242-8282 to complete their renewal over the phone or go to commonhelp.virginia.gov to complete their renewal online. They can also reach out to their local Department of Social Services or visit the Find Help in Your Area” page on Cover Virginia’s website for information on assisters and outreach workers that can assist with completing and returning information.

WHAT IF I LOSE COVERAGE?

Those who lose coverage will receive a notice in the mail along with information to file an appeal if they believe the information is incorrect. They will also receive a referral to the Health Insurance Marketplace and information about buying other healthcare coverage. According to a spokesperson from DMAS, those scared of possibly losing their coverage are encouraged to still turn their information in on time to see if they qualify for different coverage.

“The member will receive a letter notifying them of the termination of benefits – if the closure occurs on or before the 16th, their effective closure date is the last day of the same month,” Dooley said. “If they are closed from the 17th through the end of the month, their effective closure date is the end of the next month.”

Other options are available for those losing their coverage as they may be able to receive financial help through HealthCare.gov.