How To Keep Your Health Insurance Coverage As Medicaid 'unwinds' After The Pandemic

Lar Bwe, a Burmese refugee who does not speak English, recently received a letter in the post that he could not read.

The 49-year-old mother knew it was important because of the Texas state logo, so she spoke to Tha Aung, a compliance specialist at the Hope Clinic in Houston's Chinatown. It's time to renew health benefits for their youngest children, Aung explained in her own words.

Dozens of patients who have received similar notices since April have come to the clinic to renew their benefits or obtain other insurance coverage through the Affordable Care Act marketplace.

“We expect it to grow,” said Shane Chen, executive director of Hope Clinic, a federally licensed health center in Houston that serves a large population of low-income, immigrant and refugee patients.

The federal government responded to the COVID-19 pandemic by declaring a public health emergency, which allows anyone enrolled in Medicaid to maintain coverage without having to re-enroll each year. The change helped push the number of Texans enrolled in Medicaid to 5.9 million at the start of the year, from 3.9 million in 2019 before the pandemic.

Rolling enrollment ended March 31, and states are now "opening up" their Medicaid enrollments, which means Texas will begin to see who is eligible for Medicaid over the next 12 months. Some Medicaid and CHIP recipients may no longer be eligible. Others who remain eligible will need to restart the normal upgrade process.

Texas began sending a series of renewal notices to those no longer eligible in April. According to the HHSC, states can enroll Medicaid beneficiaries on June 1.

Read more : One million Texans set to lose Medicaid coverage next year

Public health experts say more than a million Texans will lose coverage over the next 12 months due to the end of continuous enrollment. Texas already has the highest uninsured rate in the nation, with 18% of residents uninsured.

Black and Hispanic people, pregnant women, young adults and low-income residents will be most affected by the changes, said Stacey Thompson, health navigator at the Houston-based nonprofit Civic Heart Community Services.

Civic Heart has sounded the alarm about the need to reapply for Medicaid through TV and radio ads and sharing information on social media, but Thompson fears many are not getting the message.

"Only 20% of affected people know what's going on," Thompson said, noting that people who don't respond to renewal notices may have a coverage "gap" when they need it most.

Read more : Texas could lose billions in Medicaid funding due to Biden policy changes

Chen worries that families who lose their children's health insurance won't realize they need to renew it after school and flu season.

“You never know when a child is going to catch a cold or fall or need stitches, God forbid.

Thompson urged anyone who receives the update notice to read and respond to it as soon as possible, even if you think you've passed the deadline.

"When they get the letters, even though they think they've missed the deadline, they still have to work on it," he said. "That's the main theme. Don't watch it."

Who is at risk of losing coverage?

HHSC has divided those who would be affected by the change into three groups. It began reporting on the first of these three groups in April and will report on the other two next month.

The first group includes people who may qualify for Medicaid. Includes over-aged and childless adults who have the right to live in their own home.

Dr. OB-GYN. Pregnant people could be included when pandemic-era rules come into effect, Vien Nguyen said. According to the HHSC, these women may be eligible for the Healthy Women Texas program.

Also Read : Ending Medicaid Coverage

"Medicaid rollout is very episodic. You buy insurance when you're pregnant," Nguyen said. "They are naturally more sensitive to changes in the system because they are not always informed of these changes."

In April, if these people have signed up for e-notifications, they should receive an “Action Required” or renewal notice by email in this envelope. HHSC said it has at least 30 days to respond.

At the HOPE Clinic, some patients said they were afraid to renew because they had high-paying jobs during the pandemic, said Trina Lay, chief compliance officer. Patients fear being turned away or having to purchase coverage, which means paying more for office visits, he said. This reassures you that they have options. You can help them sign up for a marketing plan that works for them. Your children may also be eligible for CHIP.

The second group includes people who will transition from one type of Medicaid coverage to another. They will receive a renewal notice by mail or email in July.

The third group includes people who are still eligible for coverage. They will start receiving renewal notices in September.

What if you are a Medicaid recipient?

How do I know if I need to re-register?

You will receive your renewal notice in a yellow envelope or, if you have signed up for email notifications, you will receive an email or text message.

You can also check if you need to re-enroll by logging into your account on YouTexasBenefits.com or the mobile app; Or by dialing 2-1-1 and selecting option 2 after selecting a language.

If you received an update notification by mail or email:

Follow the instructions to complete and return the renewal form. You can do it:

Online: YourTexasBenefits.com

Mail: Texas Department of Health and Human Services, PO Box 149024, Austin, TX 78714-9024

Fax: 877-447-2839

Telephone: Dial 2-1-1 and select option 2 after selecting a language.

In person: Visit a local office or community partner. You can find it online or call 2-1-1 and select option 2 after selecting a language.

If you are waiting for your update notification:

To ensure you receive notifications, please report any changes such as address, phone number, pregnancy or change of family members.

“We are really trying to beat the pace of updating your address. Be sure to update your address,” said Lindsay Lanagan, vice president of government relations and community affairs at Legacy. A dispatcher is "the first line of communication," he said.

After choosing a language, you can report by calling 2-1-1 and selecting option 2 or in person at an HHSC office or community. You can report by mail or fax on the Texas Benefits website, your Texas Benefits mobile app. . the couple

What happens if I miss the deadline to submit my renewal notice?

If you miss the minimum 30-day window to respond to a renewal notice, you may have a gap in coverage, but you should respond as soon as possible. If you respond within 90 days, HHSC will process your information without requiring a new request, officials said.

If it's over 90 days, you have to start over and apply for Medicaid. The State of Texas has 45 days to review your application and determine if you are eligible for coverage.

If you have any questions, please contact the State of Texas at 2-1-1 or YourTexasBenefits.com. You can also contact Civic Heart, which helps Texans find health insurance.

What happens after the renewal notice is sent?

HHSC will review the renewal form and ask you for the missing information. If you are still eligible for Medicaid, you will receive a notification that your coverage has been updated.

What if I'm still not sure if I qualify for Medicaid?

If you have any questions, please call 2-1-1 or 877-541-7905, select a language and press 2, Monday through Friday, 8:00 a.m. to 6:00 p.m.

You can also visit an HHSC office or community partner.

What if I don't qualify for Medicaid?

HHSC will review your renewal form to determine your eligibility for other HHSC health care programs, such as Healthy Texas Women (HTW) or the Children's Health Insurance Program (CHIP).

If you are not covered by HHSC, your application will automatically be submitted to the Federal Health Insurance Marketplace. Visit HealthCare.gov or call 800-318-2596 for more information or to find someone to help you with your application.

julian.gill@houstonchronicle.com and evan.macdonald@houstonchronicle.com

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