What is Medicaid Redetermination?

Recently, NAPCA’s Senior Assistance Center has received several calls regarding Medicaid Redetermination. We want to share some of the questions in this month’s column. If you have additional questions on Medicare, Medicaid, Affordable Care Act Health Insurance Marketplace, Social Security Retirement Benefit, Supplemental Security Income, or COVID/Flu vaccination, there are three ways you can reach us today.            

-Call our Senior Assistance Center at: (English) 1-800-336-2722,

-Email: askNAPCA@napca.org

-Mail: NAPCA Senior Assistance Center, 1511 3rd Avenue, Suite 914, Seattle, WA 98101

1. What does Medicaid Redetermination mean?

Prior to the pandemic, states were required to renew coverage for people with Medicaid coverage at least once a year and to disenroll individuals who no longer qualified for coverage. During the COVID-19 pandemic, Congress acted to ensure Americans did not lose access to critical health care by preventing states from terminating a person’s Medicaid coverage, even if they no longer qualified. Now that the PHE (public health emergency) has ended, federal law requires states to restart regular Medicaid renewals. This means that over the next 12 months, everyone with health care coverage through Medicaid will renew their coverage.

• What do I need to do for Medicaid Redetermination?

For people with Medicaid coverage:

• UPDATE your contact information with your state Medicaid agency.
• RESPOND to the Medicaid renewal form when it arrives to keep your coverage.
• CONSIDER OTHER COVERAGE OPTIONS: If you are no longer eligible for Medicaid, check if you can get coverage through your employer, through the Affordable Care Act Marketplace at HealthCare.gov, or through Medicare.

• What do I do if I lose Medicaid coverage though the Redetermination process?

If you are no longer eligible for Medicaid, you can transition to another form of health coverage, such as the Affordable Care Act Marketplace, employer-sponsored coverage, or Medicare. You can re-apply for Medicaid to find if you still qualify. Some options open their own Special Enrollment Period and Signup timeframe window. Please contact us if you have any questions about the SEP.

• I am currently enrolled in Medicaid in CA. Recently I got a part-time job, and I am worried that I may lose my Medicaid coverage after the Medicaid Redetermination process. What is the threshold for Medicaid in CA?

Medicaid is a state-run program for certain people with limited income and assets. It means each state has its own eligibility. In the case of CA, you are still eligible for Medicaid,

• if you are single and your income is below $1,677 per month, or
• if you are a married couple and your household income is below $2,268 per month.

If you are 65 or older, you have an asset limit as well that is $130,000 for single or $195,000 for couple.

Please contact us to get the information about Medicaid eligibility or contact your local Medicaid office to check your Medicaid eligibility in the state where you live.

National Asian Pacific Center on Aging (NAPCA) is a non-profit organization dedicated to improving the quality of life of AANHPI older adults and their families.  We operate a NAPCA Senior Assistance Center for Older Adults and Caregivers and is available in five different languages.