Important Update: Medicare Members to Be Impacted by Medicaid Redetermination
Attention Valued Partner,
Starting in April, states will have the ability to resume the Medicaid Redetermination process after three years of being paused due to the COVID pandemic. States can begin to initiate the redetermination process as early as February 1, 2023, and disenrollments can be effective as early as April 1 if adequate notice is given to the enrollee. Each state will set the date for when redetermination will start.
Approximately 15 million individuals will be at risk of losing Medicaid coverage. Anyone who is no longer eligible for Medicaid will be disenrolled. Wellcare members set to be disenrolled from their Medicaid plans will need your help to obtain new coverage and maintain continuity of coverage.
Be On the Lookout
Detailed communications will follow soon with state-specific information. Be sure to read these communications thoroughly and familiarize yourself with the processes and effected dates.
Be Prepared
- Refer to state-specific resources for dates and deadlines for Medicaid Redetermination.
- Assist members with upcoming redetermination changes.
- Remind current members:
- Confirm contact information is up to date.
- Watch for mail from their state requesting additional documentation.
- Respond to any request from the state promptly and within deadlines.
- Expect calls from notified members who are no longer eligible for Medicaid and need alternative coverage options.
- Remember that prospective members will be subject to eligibility determination.
Let’s ensure our members don’t experience a gap in coverage.
- Wellcare D-SNP beneficiaries who no longer qualify for Medicaid will be disenrolled after the deeming period and will need other coverage options. Wellcare implements a six-month deeming period for D-SNP (Tennessee is the exception at three months).
- For individuals no longer eligible, brokers should discuss non-dual Medicare plan options. For those eligible for Medicare, they will have a 60-day window during which they can transition to Medicare without any late enrollment penalties.
- Secondarily, members losing Medicaid eligibility may explore Ambetter Health Marketplace plan options. The window to enroll in a marketplace plan will start 60 days before their Medicaid coverage ends and will continue for 60 days after it ends.
- Current members under Wellcare D-SNP will be supported by our Wellcare partner, Centauri, to help members reapply for Medicaid and the Medicare Savings Program.
Stay Tuned
Additional information will be provided at the state level as each state confirms their Medicaid Redetermination process initiation date. A follow-up communication will be sent at that time which will provide additional resources to help you in assisting your clients.
Wellcare: Florida Medicare Members Have Begun Being Contacted About Medicaid Redetermination
Attention Valued Partner,
As previously communicated on February 10, 2023, states were able to resume the Medicaid Redetermination process as early as February 1, 2023. This process is scheduled to start on May 1 in Florida, with members beginning to receive letters from the state as early as February 1.
Anyone who is no longer eligible for Medicaid will be disenrolled. Wellcare members set to be disenrolled from their Medicaid plans will need your help to obtain new coverage and maintain continuity of coverage.
We have prepared resources to assist you in supporting your clients who may be impacted by loss of their Medicaid coverage. The resource page will provide more information about how you can assist your clients through the Medicaid Redetermination process.
Please note members can contact the state directly to update their contact information or find their renewal/redetermination date.
Resources
Wellcare’s trusted partner Centauri is available to aid members enrolled in a Wellcare Dual Special Needs Plan who may need to reapply for Medicaid and the Medicare Savings Plan. Their staff is well-trained to support our members. Centauri is specifically for the Dual Special Needs Plan, not any other redetermination.
- Toll-Free Number: 877-236-4471
- Hours of Operation: 9:00 AM – 7:30 PM EST, Monday – Friday.
Ambetter Health (Marketplace)
For more information on Ambetter Health plans and Marketplace eligibility, brokers can contact the Ambetter Health Sales Team at:
Toll-Free Number: 855-700-7985, option 3
Email: ambettersales@centene.com
Hours of Operation: 8:00 AM – 4:30 PM CST, Monday - Friday
As always, thank you for your continued partnership!
