Medicaid eligibility redeterminations and renewals to resume in April

The Department of Public Health and Human Services (DPHHS) began conducting Medicaid and Healthy Montana Kids (HMK) eligibility redeterminations on April 1 for the first time in three years.

Federal requirements during the COVID-19 pandemic led to the suspension of annual redeterminations, in order to keep every individual enrolled in Medicaid covered throughout the pandemic. However, last December’s federal omnibus spending bill directed states to resume evaluating eligibility of Medicaid enrollees on April 1.

Beginning in April and over the course of 2023, DPHHS will evaluate current Medicaid and HMK members’ eligibility for continued coverage, and renew or terminate coverage as appropriate.

DPHHS must conduct eligibility redeterminations on all individuals currently enrolled in Medicaid or HMK. These will be conducted over ten months, balancing workload with the need to conduct an expedient and quality process overall.

DPHHS encourages Montanans currently receiving Medicaid or HMK coverage to take the following steps to prepare:

Update contact information with DPHHS as soon as possible to receive important notices about Medicaid/HMK. (See below for instructions.)

Check their mail. Starting in April and throughout 2023, DPHHS will mail members a letter about their Medicaid/HMK coverage. This notification may require individuals to take action in order to maintain coverage.

Complete and return any paperwork that is received.

By April 10, individuals receiving Medicaid/HMK who have an apply.mt.gov account will be able to log in and see the month their redetermination will occur in the Check My Benefits area. Members should expect to start seeing paperwork arrive the month before the redetermination month.

As DPHHS begins processing redeterminations, some individuals’ coverage will be able to be renewed through an automated process. Those individuals will receive a letter from DPHHS telling them their Medicaid/HMK will continue.

Individuals whose coverage cannot be redetermined by the automated process will receive a packet in the mail. The best way for these individuals to complete their paperwork is online at apply.mt.gov or by mailing back the completed packet.

Households will have a minimum of 30 days to return their packet once it is received. DPHHS will send a reminder notice and text message to encourage members to complete the process.

State officials say that it’s essential individuals respond and complete their redetermination. If a member does not complete their redetermination by the stated deadline, their Medicaid/HMK coverage will end.

All Montanans receiving Medicaid/HMK should ensure DPHHS has their current mailing address to make sure this mail reaches them.

“It’s imperative that Montanans currently enrolled in Medicaid or Healthy Montana Kids take time to update their contact information with DPHHS to ensure they receive upcoming notices related to their health care coverage,” DPHHS Director Charlie Brereton said. “We’ve made various options available to complete this crucial task.”

Updates can be made the following ways:

Complete the new change of address form online at the top of apply.mt.gov. Individuals can also create an online account at apply.mt.gov. Through an online account, members can update their contact information, complete their paperwork when it’s time, and receive correspondence about their coverage.

Call the Public Assistance Helpline at 1-888-706-1535 and press 1

Mail a letter to: DPHHS, PO Box 202925, Helena, MT 59620-2925

Fax a letter to 1-877-418-4533

Go to a local Office of Public Assistance

Individuals who DPHHS identifies as no longer eligible for coverage will receive a notice telling them their coverage will end, along with information on how to pursue coverage through HealthCare.gov, the federal Health Insurance Marketplace.

To help these Montanans transition to other health insurance, DPHHS is also partnering with Cover Montana. Cover Montana is a project of the Montana Primary Care Association and connects Montanans to health insurance coverage. Cover Montana provides free, confidential enrollment help with Medicaid, HMK, and HealthCare.gov.

“Cover Montana is ready to help Montanans who are losing Medicaid coverage and need new health insurance,” said Olivia Riutta, Director of Cover Montana. “Many folks will only have a few days to sign up for new health insurance to avoid a gap in coverage, so make sure you quicky open notices from the DPHHS Office of Public Assistance. Then reach out to Cover Montana right away so we can help you sign up for new insurance through HealthCare.gov. It's more affordable than ever.”

Montanans covered by Medicaid who need help navigating this process or finding other health insurance are encouraged to call Cover Montana’s toll-free help line at (844) 682-6837 or find local in-person enrollment help at https://covermt.org/

More information about these coming changes is available at https://dphhs.mt.gov/hcsd/medicaidupdates.