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As time runs out for Medicaid renewal, officials sounding the alarm

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A stethoscope and a laptop.

BETHLEHEM, Pa. — After three years of not having to document eligibility, Medicaid recipients in Pennsylvania now have only until Saturday, April 1, to renew their application this year to continue receiving benefits.

And some recipients may find themselves ineligible to keep their Medicaid coverage if their personal circumstances, such as income or the state in which they live, have changed over the past two and a half years.

  • Pennsylvania Medicaid recipients must renew their application this year in order to continue receiving coverage
  • The renewal process starts on April 1
  • People have 30 days after getting the paperwork to turn it in

But Pennsylvania officials say they're doing all they can to get the word out.

"The department wants to make sure that folks maintain their health care coverage wherever it comes from," said Hoa Pham, deputy secretary of the state Department of Human Services' Office of Income Maintenance.

"So in addition to these multiple modes of communication, multiple warnings, multiple requests for response and receiving that paperwork, it's important to know that no one will automatically lose their health care coverage.”

Because of temporary flexibility prompted by the coronavirus pandemic, since March 2020, people in Pennsylvania who are on Medicaid or the Children's Health Insurance Program, or CHIP, have not been required to submit annual renewal paperwork.

It was part of the Family First Coronavirus response act, giving states enhanced federal funding, so states would not terminate people from Medicaid.

"It's important to know that no one will automatically lose their health care coverage."
Hoa Pham, Pennsylvania Department of Human Services

Making recipients well aware

Pham said the department is ensuring that everyone is very well aware they must submit the paperwork to maintain their coverage.

“Anyone who currently has coverage for Medicaid and CHIP will be receiving multiple communications from the department, warning them of these changes in advance and, in particular, are offering multiple modes of communication for 90 days, 60 days, and 30 days before their written annual renewal paperwork is due,” she said.

People have 30 days from when they get their renewal form to submit it.

Pham noted, “there is not a singular deadline for all families across the state. The deadlines for submitting renewal paperwork are really dependent upon that individual.”

The deadline to renew for Medicaid depends on when the person’s original registration date, so the renewal process will span a 12-month period.

This week, a group of healthcare advocates from around the region held a briefing on the situation and their concerns as the renewal process is set to start.

Amy Lowenstein, director of policy for the Pennsylvania Health Law Project, a non-profit that helps Pennsylvania get or keep their Medicaid, said all 3.7 million aid recipients will be reviewed over the next year.

"This means that there will be an unprecedented number of people being renewed and this is going to be an unprecedented amount of work for the state workers who review eligibility,” Lowenstein said.

Concerns about the process

She and the other health advocates who joined the briefing said they're concerned that staffing issues, mail delays and paperwork issues will cause people to lose their coverage.

“We have reason to be worried that this is a large group because even before COVID, over 100,000 people would lose Medicaid in a month because of paperwork problems and these folks would have to find their way back onto Medicaid,” she said.

Maripat Pileggi, the supervising attorney with Community Legal Services in Philadelphia, had a call to action for the DOH.

“The Pennsylvania Department of Human Services needs to formalize its procedures for tracking data," Pileggi said.

"Keeping an eye on how many of these renewals are overdue, how many folks who were cut off, even though they're eligible, are returning in the next month after to identify specifically on a daily basis when how much work there is to do and when it's become too much.”

"The Pennsylvania Department of Human Services needs to formalize its procedures for tracking data."
Maripat Pileggi, supervising attorney, Community Legal Services

Pileggi said she'd like to see the state extend the appeal timeframes. The state now is required to process appeals within 90 days.

Antoinette Kraus, executive director of the Pennsylvania Health Access Network, a consumer assistance program helping people across the state navigate the health insurance system, also joined the briefing.

“We really want to encourage folks, you know, to be proactive," Kraus said. "But if you do find yourself in that situation where you have been terminated from Medicaid coverage, we encourage folks to appeal."

Those looking to check their Medicaid status can visit the Pennsylvania Department of Human Services website.

People who may no longer be eligible for Medicaid or CHIP can find healthcare coverage through Pennsylvania’s marketplace Pennie.