Merrilee Logue, executive director of the Blue Cross Blue Shield National Labor Office (NLO), and Mikal Sutton, the managing director of Medicaid policy for the Blue Cross Blue Shield Association (BCBSA), joined the America’s Work Force Union Podcast to talk about the process for Medicaid redeterminations and how Blue Cross and Blue Shield (BCBS) companies are working to give American’s access to coverage.
According to Logue, Medicaid is a complex topic, and it’s become even more confusing with several recent program changes. Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. Unlike Medicare, Medicaid covers benefits like nursing home care and personal care services, and as long as workers are under a certain income threshold, they are eligible. People with Medicaid are required to renew coverage every year, which was suspended during the pandemic, creating a problem for millions of Americans.
Sutton talked about the process known as redetermination, which is what state Medicaid agencies use to determine whether individuals are eligible for coverage. She discussed the forms that need to be filled out and what to do if someone forgets to renew or has not renewed coverage. Sutton said that if someone loses their coverage, there are ways to reapply, but the method changes based on the reason behind the coverage termination. She explained the options available through the federal Healthcare Marketplace if someone is deemed ineligible due to earning more than the income limit.
Sutton also talked about the work that BCBSA and BCBS companies are doing to get the word out about redeterminations with states and other stakeholders. BCBS companies have utilized care coordinators, community health workers, navigators and assistors to educate and inform individuals about the requirements and timelines for redetermination. As of April 11, Sutton said there were 20.1 million people who had been disenrolled from Medicaid, but this number is likely higher due to reporting times.
For more information on the redetermination process, Sutton recommends that individuals visit Medicaid.gov.
Please see the supporting documents for more information:
BCBS Medicaid Redetermination
Community Resource for Medicaid Redetermination
Listen to the show above to hear more about the changes to the Medicaid redetermination process.
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