Medicaid and Medicaid Managed Care Plan Redeterminations
The Secretary of the U.S. Health and Human Services Department recently renewed a declaration on January 14, 2022 that the COVID-19 pandemic is a Public Health Emergency (“PHE”). These declarations started April 2020 and have renewed in 90-day increments through the COVID-19 pandemic.
These determinations set into motion specific protections those on Medicaid and Medicaid Managed Care plans have – namely the suspension of determining whether or not you and your family qualify for these plans.
Prior to COVID-19 and the PHE, you and your family members would have gone through a redetermination event in which you provided documentation to the State or your Medicaid Managed Care carrier to see if you continue to qualify for coverage. During the Public Health Emergency, these redetermination activities were suspended – allowing you continuous coverage even if you did not qualify based upon State of Illinois guidelines.
As of April 11, 2023, the PHE will be ended which will begin the redetermination process. Our goal is to help provide information on ways to help you navigation through this redetermination period
To help as many as possible, the State of Illinois has a very important ask: Please update your address and contact information. You can update your information in two ways:
- Call the State of Illinois Health and Family Services (HFS) hotline at 877-805-5312 (for TTY please call 877-204-1012).
- Complete an address update through the HFS website at www2.illinois.gov/hfs/address.
Once the Public Health Emergency declaration has lapsed, HFS or your current insurer will send redetermination materials to each household during the month when they would have been up for renewal if it were not for the Public Health Emergency’s continuous coverage provision.
In the event you need to seek other coverage options outside of Medicaid and Medicaid Managed Care plans or need access to plan websites for more information, please visit our insurance page at Insurance | Memorial Health. This site will help you navigate:
- Which plans Memorial Health affiliates accept
- Websites of plans from which you can access additional information
- Information on Affordable Care Act plans and local community resource contacts that can help guide you through the enrollment process
Uninsured COVID-19 Billing
The U.S. Health Resources & Services Administration (“HRSA”) established a program during COVID-19 for the reimbursement of COVID-19 testing, treatment and vaccination administration for those who are uninsured. The program contained funding from the CARES Act so that uninsured individuals with a COVID-19 diagnosis did not receive statements – helping you focus on your treatment and recovery from COVID-19.
Memorial Health, as well as all facilities nationwide, was alerted that this program will cease on March 22, 2022. What this means to you and your families is that Memorial Health affiliates cannot bill the Uninsured Program after March 22, 2022 for your COVID-19 related visit. COVID-19 services received after March 22, 2022 will be billed to you.
We understand this is a change for you and your families – as well as adds the potential for increasing anxiety and stress. Memorial affiliates have a number of options for you to navigate including:
We encourage those impacted to Contact Us | Memorial Health for more information on options you can explore. We are here to assist you and your family as you navigate through this change.