How Elevance Health is helping its members navigate the Medicaid redetermination process

It’s been three years since the federal government declared a Public Health Emergency (PHE) in response to COVID-19 that provided critical support and healthcare for families across the country. Part of ensuring healthcare coverage for as many Americans as possible included allowing all Medicaid members to stay enrolled in their plans regardless of changes in eligibility or status. That is about to change as states will begin redetermining Medicaid eligibility for all members.

Recent federal legislation separated Medicaid renewals from the PHE, which means starting on April 1 states will begin the process of ending the extended health coverage for those who no longer meet Medicaid eligibility requirements. Estimates vary widely, with some reports saying as many as 15 million people could lose Medicaid coverage due to a change in employment or other factors.

Those of us in the healthcare industry understand this process, expected to take as long as 14 months, could cause confusion and concern for those impacted. That’s why we as an industry have been working to build awareness and educational campaigns designed to reach those who may be losing coverage to help guide them to alternative healthcare coverage. 

There are options available. Anyone who loses Medicaid benefits due to a change in employment status might be eligible for employer-sponsored coverage. 

Another option is an Affordable Care Act (ACA) health plan. This is likely the best choice to remain covered. The ACA led to the creation of health plans that go beyond basic coverage but are still affordable. These plans cover essential health benefits, including emergency services, prescription drugs and pediatric services, and they offer no-cost preventive care. This means consumers pay nothing for important services such as regular wellness visits, immunizations and screenings. These services are key to avoiding and managing serious health conditions. Most people covered by these plans receive a federal subsidy, and in fact, some families who qualify for subsidies will pay nothing for coverage. The federal government has enhanced subsidies through 2025, so those who may not have previously qualified for subsidies could be eligible now.

But the key is making sure people are aware of what is happening, and if they lose coverage, guiding them on the path to securing new healthcare coverage. Our affiliated health plans have broad networks of healthcare navigators and brokers in each of the communities they serve. Also, we have created a new online tool to serve as a compass that will help any one of the millions who are potentially impacted by this process determine if they are still eligible for Medicaid, and if not, what affordable options may be available as well as access to critical local resources. 

One positive in this post-pandemic world is the number of insured Americans is at an all-time high. Now we must not take a step backward and work to ensure that no one falls through the cracks.  The pandemic reminded us of the importance of good health and having access to care when it’s needed most.

Aimée Dailey is president of Medicaid at Elevance Health and Steve Martenet is president of commercial individual business at Elevance Health.



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