RETURN TO PRE-PANDEMIC MEDICAID ELIGIBILITY
AND OPERATIONs
RETURN TO PRE-PANDEMIC MEDICAID ELIGIBILITY
In the face of COVID-19, the Families First Coronavirus Response Act (FFCRA) provided states with significant additional federal funding in order to continue the Medicaid coverage of individuals enrolled in the program. As a result, since March 2020, approximately a million Floridians who are no longer technically eligible for Medicaid have maintained their health coverage. Under FFCRA, states receiving the increased federal funding were required to maintain this moratorium on terminations until the end of the Public Health Emergency (also referred to as the “PHE”).
The Consolidated Appropriations Act (CAA) for 2023 amended FFCRA to “de-link” the requirement of continuous Medicaid from the end of the PHE and provided that the continuous Medicaid coverage requirement would end on March 31, 2023. Under Florida’s redetermination plan, the Department of Children and Families (DCF) began reviewing the eligibility of approximately 4.9 million Floridians currently on the Medicaid program in March 2023, and the reviews will continue over the next 12 months. The first terminations of those found to be ineligible or who fail to complete the renewal process will be April 30, 2023.
It is critical that all Medicaid recipients update their information with the Department of Children and Families. Individuals may be eligible for another health coverage option, or another type of Medicaid. See below for more information, and keep checking this page for updates.
The Consolidated Appropriations Act (CAA) for 2023 amended FFCRA to “de-link” the requirement of continuous Medicaid from the end of the PHE and provided that the continuous Medicaid coverage requirement would end on March 31, 2023. Under Florida’s redetermination plan, the Department of Children and Families (DCF) began reviewing the eligibility of approximately 4.9 million Floridians currently on the Medicaid program in March 2023, and the reviews will continue over the next 12 months. The first terminations of those found to be ineligible or who fail to complete the renewal process will be April 30, 2023.
It is critical that all Medicaid recipients update their information with the Department of Children and Families. Individuals may be eligible for another health coverage option, or another type of Medicaid. See below for more information, and keep checking this page for updates.
The Information, STORIES and Media
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Ending The Continuous Medicaid Coverage Requirement | The Impact on Florida Families
04/2023 Medicaid is complicated, and many recipients going through the redetermination process will need help. For those who are terminated from Medicaid, this includes help in understanding if their Medicaid termination notice is correct. The video and portal materials have been created as a training tool and resource for legal services staff, navigators, and others who are assisting recipients during the “unwinding” of the pandemic-related continuous Medicaid coverage requirement. Visit Portal and Watch Video |
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Medicaid Moves: A Guide to Florida Medicaid Changes
04/20/2023 This toolkit is designed to help walk you through the changes happening with Florida Medicaid. Inside, find information about Florida's unwinding plan, healthcare and coverage resources, and legal aid available to you. Some images and text will link you to a new site for additional resources.
Read More Here |
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Advocate Referral Form | Eligibility Assessments for Individuals Receiving Termination Notices
04/20/2023 Medicaid is complicated, and many recipients who receive a termination notice will need help. The Florida Health Justice Project (FHJP) can provide Medicaid eligibility assessments for each family member, including whether the termination notice appears (in)correct and the client's legal rights. FHJP does not charge for its services. For clients who want to be referred to FHJP for such an assessment, please complete this form and hit the Submit Button. Please also email a PDF of the client's termination notice if possible. Someone from FHJP will then email or text the client within 10 days. |
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Advocate Q & A | Florida Medicaid Recipients at Risk
Updated 03/22/2023 This Q&A explains why so many Florida parents and caregivers are likely to lose Medicaid eligibility when the continuous coverage requirement ends; what are their coverage options; and how they can prepare. Read Q&A Read more about other groups who will likely lose coverage when the extended Medicaid coverage requirement ends: |
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Advocate Update | Ending the COVID-19 Continuous Medicaid Coverage Requirement
03/14/2023 This fact sheet explains the background and status of the continuous Medicaid coverage requirement and how the end of that requirement will impact different Florida Medicaid coverage groups. Statewide Update County-specific Updates Click here for more updates |
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Waiting Room/Office Flyer on Preparing for the End of the Medicaid Continuous Coverage Period
07/29/2022 Download Flyer |
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Waiting Room/Office Referral Form for Parents & Caregivers and 19-20 Year Olds on Medicaid
04/06/2023 Download English Flyer Download Spanish Flyer |
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Pandemic-Related Medicaid Continuous Coverage Requirement is Ending: Challenges and Opportunities in Miami-Dade County
03/07/2023 This webinar discusses the continuous Medicaid coverage that has been part of the Public Health Emergency, the expected impact on Miami-Dade County residents currently on Medicaid, and what advocates should know in preparation for the return to normal eligibility and operations. Download Presentation Click here for more presentations |
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S.T.
Broward County, FL S.T. and her family are among the many Florida residents who could lose their Medicaid coverage once the federal Public Health Emergency ends. It’s a terrifying prospect for those with chronic illnesses and nowhere else to turn for affordable healthcare. Read Her Story | Read More STORIES |
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Miami Herald l Medicaid coverage starts slipping away for almost 1 million Floridians in April
01/21/2023 The state is preparing for a great “unwinding” as millions of Floridians currently on Medicaid will be undergoing eligibility redeterminations after the pandemic related moratorium on terminations ends in March. Over 900,000 households have “one or more family members who are likely ineligible.” Some will be enrolled in other subsidized insurance coverage, but others will become uninsured because Florida is one of only 11 states that does not cover low income adults under Medicaid expansion. Read More - Click for more Media - |
ADDITIONAL RELEVANT RESOURCES | Last updated on 04/20/2023
- DCF plan for unwind of the continuous Medicaid coverage requirement
- Covering Florida Statewide Navigator List
- Covering Florida | Consumers can also go directly to the Covering Florida website to schedule their own appointment.
- CMS letter to State Health Officials (SHO) letter outlining new requirements that impact state activities in unwind from the COVID-19 public health emergency. The SHO also addresses changes to the conditions which states must meet to receive increased federal medical assistance percentage (FMAP), reporting requirements, and new enforcement authority for CMS to ensure state compliance with eligibility redetermination and reporting requirements.
- CMS guidance on a temporary Exceptional Circumstances Special Enrollment Period (SEP) for consumers losing Medicaid or CHIP coverage due to unwinding of the Medicaid continuous enrollment condition. New flexibility will be provided by facilitating access on HealthCare.gov to an SEP, referred to as the “Unwinding SEP.”
- Centers for Medicare and Medicaid Services (CMS) Informational Bulletin | On Jan 5, 2023, CMS issued an informational bulletin that provided key dates related to the expiration of Medicaid continuous enrollment condition, including an end date of March 31, 2023. States will have up to 12 months to initiate, and 14 months to complete, a renewal for all individuals enrolled in Medicaid and the Children's Health Insurance Program (KidCare).
- ASPE Projections of Enrollment Impacts of Expiration of COVID Medicaid Continuous Enrollment Provision (August 19, 2022) This report includes HHS estimates regarding the number of individuals nationwide who are predicted to lose Medicaid coverage after the PHE ends. The report includes those who will lose Medicaid because they are no longer eligible (8.2 million), as well as those who are still eligible but will likely lose Medicaid due to administrative issues (6.8 million). An estimated 383,000 current Medicaid recipients in non-expansion states will fall into the "coverage gap".
- Centers for Medicare and Medicaid Services (CMS) | Updated Guidance Related to Planning for the Resumption of Normal CHIP and BHP Operations Upon Conclusion of the COVID-19 PHE (March 2022)
- CMS | Summary of Best and Promising State Practices from CMS/State Discussions
- CMS | Overview of Strategic Approach to Engaging Managed Care Plans to Maximize Continuity of Coverage as States Resume Normal Eligibility and Enrollment Operations
- Notice of Case Action: Medicaid Approval and Ineligible Determination | The Florida Department of Children and Families (DCF)'s Notice of Case Action sent to current Medicaid enrollees who have maintained eligibility due to the PHE. The Notice underscores the need to contact DCF with any updates.
- Covering Florida Navigators, part of Florida Covering Kids & Families (FL-CKF), provides outreach and enrollment services free of charge to Floridians looking for healthcare options through the Federal Health Insurance Marketplace. Local navigator contact information can be found here.
- Kaiser Family Foundation | States Project Declining Medicaid Enrollment, Slower Total Spending Growth & Rising State Costs After the PHE Expires
- Kaiser Family Foundation | What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access
- This 50-state report conducted by Kaiser Family Foundation and the Georgetown University Center for Children and Families in January 2022 presents a snapshot of actions states are taking to prepare for the lifting of the continuous enrollment requirement, as well as key state Medicaid enrollment and renewal procedures in place during the PHE.
- Health Management Associates | HMA Weekly Roundup
- National Health Law Program | Unwinding the COVID-19 Public Health Emergency: Checklist of Redeterminations
- Center on Budget and Policy Priorities | Webinar Series - Unwinding the COVID-19 Medicaid Continuous Eligibility Provision
- The federal government maintains a website for all material related to the unwinding of the continuous Medicaid coverage provision.
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