Up to 300K people could lose Medicaid coverage when SC reviews eligibility

COLUMBIA, S.C. (WCSC) – South Carolina will quickly start reviewing who’s eligible for Medicaid for the primary time in three years, and the state company that oversees this system says as much as round 300,000 individuals may lose their protection within the subsequent yr.

Earlier than the pandemic, the South Carolina Division of Well being and Human Companies reviewed Medicaid eligibility yearly to find out who nonetheless qualifies.

For the final three years, individuals may very well be added to Medicaid however typically not eliminated — except they requested to be eliminated, moved out of state, or died — due to the federal COVID public well being emergency.

However that’s coming to an finish, and beginning April 1, states can resume disenrolling individuals once more.

“For our Medicaid members who’ve been enrolled in Medicaid for some time, that is going again to the method that existed in 2019 and earlier than. We’ve a number of members who’ve joined Medicaid and been enrolled in Medicaid for the primary time throughout that interval, in order that’ll be a little bit of a brand new course of,” South Carolina Division of Well being and Human Companies Communications Director Jeff Leieritz stated.

The Division of Well being and Human Companies will take a full yr to hold that course of out, from April 2023 to March 2024, following the steerage of its stakeholders and the federal authorities.

It estimates Medicaid enrollment will drop from about 1.3 million South Carolinians to simply over 1,000,000, the place it was earlier than the pandemic.

“There shouldn’t be many who’re at the moment underneath 19 [years old] who’re dropping protection,” Leieritz stated. “Nothing about our enrollment course of or utility course of or eligibility course of for these people has modified.”

Numerous the South Carolinians who will likely be disenrolled are those that beforehand certified as youngsters as a result of their household’s earnings was beneath a sure stage, in accordance with DHHS.

Now they’re adults and have aged out of that protection eligibility however have remained on Medicaid the final three years as a result of federal legislation prohibited eradicating them.

Beginning April 1, the division of well being and human companies will mail out evaluation types to everybody at the moment on Medicaid in South Carolina.

As a result of the state is doing this in batches as a substitute of , some individuals will obtain their types in early April whereas others may get it as late as simply over a yr from now, or any time in between.

They’ve 60 days after the shape is mailed to fill it out and return it.

“If any person receives the annual evaluation type and doesn’t return it inside 60 days, they’ll doubtless lose their protection,” Leieritz stated, including individuals who miss the deadline ought to contact DHHS and return the finished type out late, as they could nonetheless be capable of be retroactively enrolled if they’re eligible.

If the division of well being and human companies is ready to decide by itself that somebody continues to be eligible for Medicaid, these individuals will obtain a continuation of advantages discover within the mail, so they won’t must fill out the evaluation type.

Whereas DHHS doesn’t anticipate many youngsters to lose protection, except their household’s eligibility modified, the potential for teenagers to be dropped as a result of a mother or father or guardian did not return the evaluation type is what considerations Wholesome Learners.

The Columbia-based nonprofit works in additional than a dozen counties throughout South Carolina, within the Upstate, Midlands, Pee Dee, and Lowcountry.

Final yr, it supplied greater than 2,000 youngsters from low-income households with healthcare, together with dental, imaginative and prescient, and psychological well being.

“Our concern is that we take a toddler to an appointment, assume they’re on Medicaid, and are available to seek out out that perhaps they’ve been disenrolled or would possibly now not be eligible, or most likely extra sometimes, they simply haven’t finished the paperwork to ensure they’ve steady protection,” Wholesome Learners Govt Director Amy Splittgerber stated.

Many of the youngsters they serve are on Medicaid, so in the event that they lose protection, it may have an effect on how a lot care Wholesome Learners is ready to present different youngsters who aren’t Medicaid-eligible however are uninsured.

“We’ll most likely do some mass mailings to all of our households to ensure that they’ve stuffed out the paperwork, that they’ve that continuation of protection in order that they will get the care they want and we are able to decrease our prices of out-of-pocket medical charges,” Splittgerber stated.

Folks can go to the DHHS “Annual Evaluation” webpage to seek out pattern evaluation types and reality sheets in each English and Spanish.

They’ll additionally replace their contact info by clicking right here, so as to add cellphone numbers and e-mail addresses to obtain notifications when their evaluation type has been despatched.

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