PROVIDER ALERT July 2015 Maryland Medicaid Renewals … · 2015. 7. 12. · c. Complete Build Your...
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PROVIDER ALERT July 2015 Maryland Medicaid Renewals Redetermination Process Medicaid recipients must renew their eligibility every 12 months. This process is also known as getting a "redetermination." Redeterminations for most Medicaid recipients will now be processed in Maryland Health Connection. Maryland Health Connection will process redeterminations for the following recipients: • Under 65 years of age • Parent or caretaker relative of a minor child • Pregnant women • Children enrolled in Medicaid • Former foster care children Some redeterminations will continue to be process through the local Department of Social Services (DSS). The local DSS will continue to process redeterminations for the following recipients: • Over 65 and are not a parent of caretaker relative of a minor child • Blind • Disabled • Living in a nursing facility • Current foster care children Recipients are mailed letters from Maryland Medicaid 45-60 days in advance of their redetermination deadline. We encourage you to discuss redetermination requirements with your patients to make sure they are completing their redetermination applications timely. Attached are flyers outlining the redetermination process. We encourage you to make these flyers available to your staff and patients. For recipients who are enrolled in a Managed Care Organization : If a recipient loses coverage due to not completing his or her redetermination application, the recipient will be re-enrolled into the same Managed Care Organization he or she was in previously if the gap in enrollment is less than 120 days.
Transcript of PROVIDER ALERT July 2015 Maryland Medicaid Renewals … · 2015. 7. 12. · c. Complete Build Your...
PROVIDER ALERT
July 2015
Maryland Medicaid Renewals Redetermination Process
Medicaid recipients must renew their eligibility every 12 months. This process is also known as getting a "redetermination." Redeterminations for most Medicaid recipients will now be processed in Maryland Health Connection. Maryland Health Connection will process redeterminations for the following recipients:
• Under 65 years of age • Parent or caretaker relative of a minor child • Pregnant women • Children enrolled in Medicaid • Former foster care children
Some redeterminations will continue to be process through the local Department of Social Services (DSS). The local DSS will continue to process redeterminations for the following recipients:
• Over 65 and are not a parent of caretaker relative of a minor child • Blind • Disabled • Living in a nursing facility • Current foster care children
Recipients are mailed letters from Maryland Medicaid 45-60 days in advance of their redetermination deadline. We encourage you to discuss redetermination requirements with your patients to make sure they are completing their redetermination applications timely. Attached are flyers outlining the redetermination process. We encourage you to make these flyers available to your staff and patients. For recipients who are enrolled in a Managed Care Organization: If a recipient loses coverage due to not completing his or her redetermination application, the recipient will be re-enrolled into the same Managed Care Organization he or she was in previously if the gap in enrollment is less than 120 days.
Reapplying for coverage is easy
You will reapply for Medicaid coverage once a year. When you get a letter saying you need to reapply (or if you think it’s time for you to do so), you can reapply any of these ways:
Save time by having this information readyHave the following information ready when you reapply through MarylandHealthConnection.gov or in
person.
You can also download this checklist at :
After you reapplyIf you are eligible for Medicaid and re-enroll, your Medicaid coverage will continue.
Reapplying for Medicaid coverage
Household monthly income (including pay stubs, W-2 forms, or tax returns if you have them)
Social Security numbers or document numbers for each household member reapplying for coverage
Date of birth for each household member reapplying for coverage
Immigration information, if applicable
Follow these instructions if you: - Are under 65 - Are a parent or caretaker relative of a minor child - Are a pregnant woman - Have a child enrolled in Medicaid - Are a former foster care child
Online at MarylandHealthConnection.gov
Call Maryland Health Connection at 1-855-642-8572 (TTY: 1-855-642-8573)
Use this step-by-step guide to create an account and complete your application:
At the endbe sure to click “Proceed to Enrollment.”
After you enroll, check your account’s “My Inbox” to see if any additional documents are needed to verify your information.
Learn mor
Visit your local
Local Health Department
or
Connect with a
https://www.marylandhealthconnection.gov/assets/MedicaidRenewals2015.pdf.
Translation services are available.
https://www.marylandhealthconnection.gov/wp-content/uploads/2014/09/MHC_ApplicationCheckList_091813-copy.pdf
https://mmcp.dhmh.maryland.gov/Documents/HBX-Redet%20FAQs_FINAL_DISTRIBUTION_1.21.15.pdfe at:
Request a paper application by calling Maryland Health Connection and apply by mail
at: http://marylandhbe.com/application-counselor-sponsoring-entities/
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Reapplying for coverage s easy
When you get a letter saying it’s time to reapply, the letter will come with a form that has your current application information. If you don’t need to make changes to the information on the form, simply sign and return it.
If your information has changed or you did not receive the form, you can reapply online at marylandsail.org or at your local
Save time by having this information readyHave the following information ready when you reapply online at marylandsail.org or in person:
Need help reapplying for coverage?
If you have questions about the application or don’t have access to a computer, don’t worry:
Reapplying for Medicaid coverage
Household monthly income (including pay stubs, W-2 forms, or tax returns if you have them)
Social Security numbers or document numbers for each household member reapplying for coverage
Date of birth for each household member reapplying for coverage
Immigration information, if applicable
Translation services are available.
Follow these instructions if you are:
Call the Maryland Access Point at 1-844-627-5465 (TTY: #711)
Visit your local
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maureenregan
Cross-Out
Medicaid Renewals
In order to have your Medicaid eligibility reassessed through the Maryland Health Connection, create an account and
submit a new application. NOTE: YOU MUST COMPLETE THE SPECIAL ENROLLMENT SECTION AS DESCRIBED IN STEP 8.
Create Account From homepage: http://www.marylandhealthconnection.gov
1. Click Enroll Now
2. Click Create Account
3. Complete all information with a red asterisk (*) and
click Create Account
4. Log in with your new User ID and Password you
created
Complete Application After logging in, from Account Home page
1. Click Start New Application
Click Next to advance to the next screen throughout.
2. Complete Build Your Household Section
a. Select Yes to indicate you want to be evaluated for Help with Health Care Cost.
b. Complete required information for all household members indicated with a red asterik (*).
c. Complete Build Your Household – Individual Details for each family member
Enter Social Security Number (SSN).
If you do not have an SSN, system will not allow you to proceed. You must contact the Call Center, 1-855-642-8572 (TTY: 1-855-642-8573).
d. Provide Home Address
Or, Indicate No Home Address if the applicant is
homeless.
Review information for accuracy, Click Confirm
Visit Maryland Health Connection
Create Account Start New Applicaiton Answer Special
Enrollment Questions Complete & Sign
Application
Best Practice: Type First and Last Name in Title Case
Email is optional and allows user to retrieve a forgotten User ID
Confirm Your Identity page appears. If your identity cannot
be confirmed after calling Experian, visit a local Health
Department or Department of Social Services office.
3. Complete Individual Details Section
a. Indicate if applicant(s) have been determined disabled by the Social Security Administration.
b. Select Citizenship/Immigration Status of all household members.
4. Complete Tax Information Section
a. Enter annual income for the household for the current year and expected income for next year in Income Confirmation screen.
b. Indicate if household income for the current month is greater than amount indicated.
If applicant is not eligible for financial assistance, the Household Income and Household Deductions sections are skipped.
5. Complete Household Income Section
a. Indicate if anyone is currently employed.
Answer No when the only income earner is self-employed.
6. Complete Income Deduction Section
a. Indicate Yes for Prior Medical Expenses
7. Complete Additional Questions Section
a. Select Yes to indicate family member currently have Health Insurance.
b. Complete Currently Enrolled in Health Coverage
Policy Coverage Date and Effective Dates must match. Policy Coverage End Date and Effective End Dates must match. Use end date provided in the letter received.
8. Complete Special Enrollment Section
a. Select all household members to indicate they will lose health insurance within the next 60 days.
b. Enter date provided in the letter received
c. Review and Click Confirm
9. Complete Application Review section
10. Review Eligibility Determination and Select Desired
Program
11. Complete Additional Medicaid Questions, if required
12. Document Upload appears if verification documents
are required.
a. Click Next to pass Document Upload. Documents can be uploaded at a later time.
a. Click Proceed to Enrollment
Final Confirmation page appears
Check one eligible program per person to
enroll
If a citizenship/immigration selection is not made for an individual, the person
will not be eligible for Medicaid or a QHP.
Indicate if income for current month is above Medicaid threshold for
household.
