Medicaid Renewal

• The federal government declared a public health emergency when the COVID-19 pandemic began. Since then, state agencies have continued health care coverage for all medical assistance programs, even for people who are no longer eligible, called the continuous coverage requirement.
• The Consolidated Appropriations Act was signed into effect on December 23rd, 2022. This omnibus bill decoupled the continuous coverage requirement from the public health emergency effective March 31, 2023. This means on April 1, 2023, all states returned to normal enrollment processes, including redeterminations and processing reductions/closures of coverage. While Virginia initiated its first month of redeterminations in March of 2023, reductions/closures of coverage did not begin until April 30, 2023.

• States will have 12 months to make sure Medicaid members are still eligible for coverage. 
• Cancellations or reductions of coverage for members will not occur without Medicaid asking them for updated information. Starting in March 2023, Medicaid began reviewing members’ coverage. They may be able to renew your case without asking you for anything, and if so you will receive a letter in the mail letting you know your healthcare coverage will continue. If they do not have all information necessary to renew your benefits, they will send you a form or a checklist to complete and return.

It is important for all eligible Virginians to get and stay covered. If a member no longer qualifies for health coverage from Virginia Medicaid, they will get:

• Notice of when the Medicaid coverage will end,
• Information on how to file an appeal if the member thinks the decision was incorrect, and
• A referral to the Health Insurance Marketplace and information about buying other healthcare coverage.

NOTE: Unless a member has died, moved from the state permanently, or requested closure of their case, Medicaid cannot close your case unless they ask for updated information prior to making a decision that you are not eligible. It is important to keep your eye out for any mail regarding your health care coverage so that you can return your information on time. If you think you might not stay covered, please return your information anyway so Medicaid can look at your situation and send your full information to the Marketplace for review. If you do not return the information they need to review your case, they cannot automatically send your information to the Marketplace so that they can determine whether you are eligible for that type of coverage or the Advanced Premium Tax Credits.

Members can:

• Update their contact information by calling Cover Virginia at 1-855-242-8282 or online at commonhelp.virginia.gov. Current contact information must be on file, such as a mailing address and phone number(s). This is to ensure members receive important notices if Medicaid needs to contact you for more information.
• Watch for and respond quickly to notices about their coverage.
• Sign up for email and text updates, follow Cover Virginian and Moms In Motion on social media, and visit Cover Virginia at coverva.org and facebook.com/coverva/

• The renewal process will begin two months before your renewal is due, shown in the resource “Understanding the Renewal Calendar”. For example, if your case renewal month is February 2022, Medicaid will start your renewal process in October of 2023 (see Line #8 under Column A). If you don’t know your renewal date, you can call your local Department of Social Services (https://www.dss.virginia.gov/localagency/index.cgi), or Cover Virginia (1-855-242-8282) (TTY: 1-888-221-1590).

• States have 12 months to begin redeterminations and two months to complete clean-up efforts. Virginia’s 12-month timeframe runs from March 2023 to February 2024, with clean-up months between March and April 2024.

• Members or their authorized representatives can do this by calling Cover Virginia at 855-242-8282 or by going to coverva.org and clicking on the “Ask Us Anything” button from Mon-Fri 8am-7pm.
• They can also submit changes online to CommonHelp at commonhelp.virginia.gov, or by contacting their local Department of Social Services.

• They should contact a friend, family member, or local organization that can receive the mailed paperwork for them, and update their address by contacting Cover Virginia, their local Department of Social Services agency, or going online to CommonHelp at commonhelp.virginia.gov to report the change.

• The Department of Medical Assistance Services (DMAS) and the Department of Social Services (DSS) have collaborated to prepare workers for resuming manual redeterminations, including increasing automation to reduce the amount of manual work. Workers are expected to continue to process applications along with redeterminations. DMAS has expanded the Cover Virginia operations by adding a new redetermination call center and processing unit to supplement the work force at local DSS agencies.

• Virginia is taking a time-based approach to redeterminations. In addition to timely, or currently due, redeterminations, the state will also redetermine overdue cases. 
• For more information on when redeterminations will occur, see the resource “Understanding the Renewal Calendar” on the Cover Virginia website.

• Letters and forms generated from the eligibility system are sent on a household basis. If all members in the family are on the same case, then they will receive one set of information.

• Letters and forms generated from the eligibility system are sent on a household basis. If all members in the family are in the same case, then they will receive one set of information.

• There are a few small adjustments to the documentation, such as updates to reflect annual federal poverty-level increases. However, the renewal documentation is essentially the same. The form was redesigned in 2019 to include information on how to renew in each modality (paper, online, and by phone) on the first page.

• A member can call Cover Virginia at 1-855-242-8282 to renew over the phone, or they can go to commonhelp.virginia.gov to renew online. 
• They can also contact their local Department of Social Services or go to Cover Virginia’s Find help in your region page for information on assistants and outreach workers who can help them complete and return forms.

• First, a member needs to review the renewal calendar to determine when it is time to renew. If it is time to renew and they have not gotten a form, they can contact their local Department of Social Services or Cover Virginia for more information.

• When a member or family submits their information during the grace period, they will be re-evaluated back to the date of closure. If they are eligible, they will be reinstated back to the closure date with no enrollment gap.

The member will receive a letter informing them that their benefits are being terminated; if the closure occurs on or before the 16th, their effective closure date is the final day of that month. If they are closed from the 17th until the end of the month, their effective closure date is the end of the next month (unless in the case of death, where the effective closure date is the day of death).