If you count on Medicaid benefits as you care for your child with complex medical conditions or special health care needs, there are some changes you should know about. Earlier this year, Medicaid resumed a process for reviewing who can keep getting benefits. Why is this happening? And what does it mean for you and your child? We break it down for you here.

Why this change?  The Medicaid program has a monthly process called redetermination. This  decides who is eligible for benefits. All states follow this process. It was put on hold during COVID-19 to help at-risk people. But over time, many ineligible people continued to receive Medicaid benefits. Now, states are resuming the Medicaid redetermination process. 

What does this mean?   Some Medicaid recipients who were eligible at the start of COVID may now be ineligible. They could lose their Medicaid benefits over the next year. But that does not mean everyone will lose their benefits. 

If you receive Medicaid benefits for your child, you must meet certain requirements to continue to qualify. This includes income level. States are required by law to periodically ensure Medicaid recipients meet those requirements. Those who no longer meet them must be removed from the program. 

Why would someone lose Medicaid benefits?

There are several reasons. Some of them could be: 

• An increase in household income.
• A change in the household, such as no longer caring for a minor.
• Failure to update contact details with your state Medicaid agency. This may mean you have not received renewal notices.
• A misunderstood request because English is a second language.

Many times, it is about keeping contact details up to date with your state Medicaid agency. Or a paperwork issue that can be fixed. 

What should I do? First things first. It is key to complete the renewal process. 

• If you have Medicaid benefits now, you will get a notice from your state’s Medicaid agency. You may have already received this by email or mail. You may also find this in your Medicaid online portal. See below for links to the Florida and Texas portals. 
• Complete your Medicaid renewal packet as soon as possible. Make sure your contact details are current. This is key if you’ve moved since COVID began.
• Some Medicaid recipients will be automatically renewed. If so, you will receive a notice that your Medicaid renewal has been approved. And your coverage will continue.

Where can I learn more? 
If you live in Florida:

• Visit Florida MyACCESS portal to learn more about Medicaid redetermination, fill out your forms, and update your information. 
• For more information, visit the Florida Department of Children and Families (DCF).

If you live in Texas: 

• Visit your Texas Benefits portal to manage your benefits.
• For additional information and questions, visit the Texas Health and Human Services website. 

We Can Help

Call us today at (833) 208-7770 to get started.

Imagine Pediatrics is dedicated to improving the health and lives of children with special health care needs. We provide virtual-first care and support in the home, 24/7. We don’t replace your child’s current care team. We partner with them to give your child the high-quality help they need, whenever they need it. This includes answering questions about RSV and how to prevent it. Since our services are part of your child’s existing health plan benefits, there’s no cost to you! Call us today at (833) 208-7770 to get started.