Montana DPHHS resumes Medicaid Beneficiary Eligibility Verification

HELENA — During the COVID-19 pandemic, the federal government has ordered that anyone in a state Medicaid program can remain enrolled until the public health emergency ends. Now, effective April 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 stay on Medicaid.

“We’ve really put a lot of effort into making sure our staff are trained, ready, our system is ready to support this,” said Jessie Counts, administrator of DPHHS’s community and social services division. “We hope this will be a supportive process for the members as we go through this.”

Over the next ten months, DPHHS staff will assess all members of the Medicaid and Health Montana Kids programs to see if they still meet the requirements to participate. Early next year, all program participants will receive 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 someone might no longer be eligible for the scheme, but one of the most common is if their income is above the qualifying range.

Leaders say it is essential that people update their contact details, to ensure they will receive their renewal packet. You can do it on the site apply.mt.gov or by calling the DPHHS hotline at 1 (888) 706-1535.

“All the information we send is delivered by courier,” Counts said. “We’ve been working hard to try and get as many addresses corrected as possible, but really that’s the best thing people can do at this stage to prepare – is to make sure we we have the right information.”

At apply.mt.gov, recipients can also create an account. After April 10, people with accounts will be able to see in which month their revaluation will take place. They can expect to see documents from DPHHS within a month.

The number of people using Medicaid and Healthy Montana Kids has steadily increased during the public health emergency, from 277,301 in January 2021 to 322,061 in January 2023. The numbers indicate that DPHHS does not predict how many people in Montana may no longer be eligible for coverage.

“So much has changed for many Montanans since March 2020, we are unable to speculate on these cases,” she said. “Instead, we will consider it on a case-by-case basis as we make this redetermination.”

People who receive a packet requesting more information will have 30 days to respond. If they do not complete the review documents by the deadline, their coverage will end.

If someone is on the verge of losing coverage, the state partners with Cover Montana to help prepare them for the next steps. Cover Montana is a network of organizations, including the Montana Primary Care Association, that helps people understand and connect with health insurance options.

Director Olivia Riutta said they were already getting questions about the change.

“We have an in-person team, we have a phone team that is ready and able to help people make sense of this process, and for people who lose their Medicaid coverage because they have excess income, our team is ready to help them understand where they could sign up for coverage – whether through an employer-sponsored plan or through the health insurance marketplace at HealthCare.gov,” she says.

Riutta said people who were on Medicaid before COVID may be familiar with the redetermination process, but it will be new to many who have joined the program since.

“Right now we’re answering a lot of questions about the process, so people understand what they can do to prepare,” she said.

Riutta encouraged anyone who can create an account on apply.mt.gov to do so. In addition to finding their month of new determination, 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 the Cover Montana helpline at 1 (844) 682-6837.

“We do as much or as little as anyone needs,” Riutta said. “Sometimes it’s just about answering questions, sometimes it’s about sitting down with someone and walking them through the application and registration process. And then we spend a lot of time talking to people after the fact if they have questions about how to use their coverage.

The accounts said that if a person’s Medicaid benefits end because the department was unable to obtain them, they can reapply if they believe they are still eligible.

The return to annual reassessments isn’t the only change. DPHHS will also implement a new state-level rule that had been put on hold while redeterminations were put on hold. Montana previously approved coverage for Medicaid beneficiaries for a full year. Now, the department will recheck the eligibility of most beneficiaries during the year if they report any changes, such as moving house, marriage or divorce, someone joining or leaving, or a change in income.