HELENA — During the COVID-19 pandemic, the federal government directed that everyone on a state Medicaid program could remain enrolled through the end of the public health emergency. Now, as of Apr. 1, that policy has ended – and for the first time in several years, the Montana Department of Public Health and Human Services is determining whether people can remain on Medicaid.
“We've really put a lot of efforts into making sure our staff are trained, ready, that our system is ready to support this,” said Jessie Counts, administrator of DPHHS’ Human and Community Services Division. “We're hoping that it's a supportive process for the members as we go through this.”
Over the next 10 months, DPHHS staff will evaluate all members of the Medicaid and Health Montana Kids programs to see if they still meet the requirements to take part. By early next year, everyone in the programs will get a letter – either saying they have been automatically renewed or telling them they need to provide more information.
Counts said there are a number of reasons why someone might no longer be eligible for the program, but one of the most common is that their income rises out of the qualifying range.
Leaders say it’s vital that people update their contact information, to make sure they’ll receive their renewal packet. You can do that on the website apply.mt.gov or by calling the DPHHS Public Assistance Helpline at 1 (888) 706-1535.
“All of the information that we send is delivered by mail,” said Counts. “We've made a lot of efforts to try to get as many corrected addresses as we can, but that's really the best thing people can do at this point to prepare themselves – is to make sure that we have the correct information.”
On apply.mt.gov, recipients can also create an account. After Apr. 10, people with accounts will be able to see what month their reevaluation will occur. They can expect to see paperwork from DPHHS in the month before that.
The number of people using Medicaid and Healthy Montana Kids grew steadily during the public health emergency, rising from 277,301 in January 2021 to 322,061 in January 2023. Counts said DPHHS is not projecting how many people in Montana might no longer be eligible for coverage.
“So much has changed for many Montanans since March of 2020, we are not able to speculate on those cases,” she said. “Instead we're going to look at it case by case at the point in time when we do that redetermination.”
People who receive a packet seeking more information will have 30 days to respond. If they don’t complete the redetermination paperwork by the deadline, their coverage will end.
If someone is set to lose coverage, the state is partnering with Cover Montana to help them prepare for the next steps. Cover Montana is a network of organizations, including the Montana Primary Care Association, that helps people understand and get connected to health insurance options.
Director Olivia Riutta said they’re already receiving questions about the change.
“We have an in-person team, we have a phone team who are ready and able to help folks make sense of this process, and for folks who are losing Medicaid coverage because they're over-income, our team is ready to help them understand where they might be able to enroll in coverage – whether it's through an employer plan or through the health insurance marketplace at HealthCare.gov,” she said.
Riutta said people who were on Medicaid before COVID may be familiar with the redetermination process, but it will be new for many who joined the program since.
“Right now, we are answering a lot of questions about the process, so that folks understand what they can do to prepare,” she said.
Riutta encouraged anyone who can create an account at apply.mt.gov to do so. In addition to finding their redetermination month, she said it will allow people to get copies of their notices faster and complete their paperwork online.
You can find local help in your area by going to covermt.org. You can also call Cover Montana’s Help Line at 1 (844) 682-6837.
“We do as much or as little as someone needs,” said Riutta. “Sometimes it's just answering questions, sometimes it's sitting down with somebody and walking them through that entire application and enrollment process. And then we spend a lot of time talking to folks after the fact if they have questions about how to use their coverage.”
Counts said, if someone’s Medicaid benefits do end because the department wasn’t able to get hold of them, they are able to reapply if they believe they are still eligible.
The return to annual re-evaluations isn’t the only change. DPHHS will also be implementing a new rule at the state level that had been on hold while redeterminations were paused. Montana previously approved Medicaid recipients’ coverage to last for a full year. Now, the department will recheck most recipients’ eligibility during the year if they report changes, like moving, getting married or divorced, having someone join or leave the household, or having their income change.
