The public health emergency initiated due to Covid-19, is scheduled to end on May 11, 2023. Anyone receiving Medicaid (Medical Assistance), will be asked to renew their eligibility for Medicaid in a process that is being called the “unwinding”. Those ineligible Medicaid enrollees that were allowed to receive Medicaid during the pandemic, will no longer be allowed to receive benefits.
During the pandemic, Medicaid renewals were automatic and enrollees were granted continuous coverage even if circumstances had changed and they otherwise would not have been allowed to receive benefits. The Department of Human Services (DHS) is now going to review approximately 3.7 million cases to determine who is eligible for benefits. Starting April 1, 2023, DHS will begin terminating some people from Medicaid.
During this renewal process, enrollees will be notified 90 days before their renewal date that a renewal is forthcoming and that enrollees should contact DHS to makes sure their contact information is accurate. Sixty days (60) before the renewal date, enrollees can renew online or by phone. Thirty (30) days before the renewal date, DHS will mail a renewal packet if an enrollee has not already renewed. The completed forms can be mailed to DHS or brought to the local County Assistance Office. If you receive a notice that you are no longer eligible for benefits, you can file an appeal.
For those with long term care Medicaid benefits, received either in a nursing facility or at home through a Waiver Program, the reasons for a denial of eligibility might be due to increased income that exceeds the Waiver program income cap or excess resources. Thankfully, the excess resources and exceeding the income cap during the public health emergency will not result in an overpayment claim. However, after March 31, 2023, those excess resources or income that is too high can affect eligibility.
Medicaid qualification planning may be needed to keep eligibility for long term care Medicaid. Planning could include spending down excess resources. With significant excess resources, such as proceeds from the sale of a house or an inheritance, there is planning that can be done to save some of those proceeds from the nursing home costs. The planning often involves the use of a Medicaid qualifying annuity. And for those with less than $500 over the income cap for a Waiver program, there is also planning that can be done to keep the Waiver benefits, including the use of a Pooled Special Needs Trust. In either of these cases, you should seek the counsel of an experienced elder law attorney.