Are you at risk of losing your Medicaid coverage?
Almost a million Floridians are slated to lose their Medicaid coverage starting in April once the federal COVID-19 emergency comes to an end. Florida is one of 11 states that did not expand Medicaid through the Affordable Care Act, which means tens of thousands of Florida families are expected to fall into the Medicaid access gap.
This gap occurs when families have incomes that are above the state’s eligibility for Medicaid but are below the federal poverty line ($13,590 for an individual in 2022, $23,030 for a family of three, according to healthcare.gov). They won’t be eligible for Medicaid or for coverage within the Affordable Care Act marketplace.
During the pandemic, to make sure there was continuous access of care, Medicaid participants were automatically re-enrolled, but now, their eligibility will be checked again. In Florida, more than 1.87 million people gained Medicaid coverage from March 2020, when the pandemic began, to December 2022, a 50 percent increase, according to state enrollment data. As of December, more than 5.6 million people in Florida were covered by Medicaid.
“This is going to be a major, major wave of people losing coverage,” said Shirley Dominguez, program coordinator at Epilepsy Alliance Florida Navigation Program. The program offers free healthcare enrollment assistance and guidance across Miami-Dade, Broward, Monroe, Palm Beach, Martin, St. Lucie, Indian River and Okeechobee counties.
READ MORE: Medicaid coverage starts slipping away for almost 1 million Floridians in April
How can you check your eligibility? And what happens if you lose coverage?
Here’s an FAQ guide:
What is Medicaid and who is eligible in Florida?
In Florida, to qualify for Medicaid, a health insurance program run jointly by the federal government and the states, a person must be considered low income and be either pregnant, have kids under 18, be blind, have or live with a family member who has a disability, or be at least 65, according to Benefits.gov. There are income requirements.
“Florida’s Medicaid program covers children aged 5 and younger in households that make $33,408 or less and older children whose parents make up to $31,795. But there is no coverage for parents who earn more than $7,000 per year and adults with no children are ineligible no matter how little they earn. Only four states in the nation have stricter Medicaid eligibility,” the Florida Policy Institute told the Herald/Times.
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How to check your eligibility? What should you be doing now?
Dominguez said people should expect to receive letters about the recertification process starting in March. And you should start preparing now to make the recertification process easier. Whether you get recertified or not will depend on a variety of factors including household size, income and the age of your children.
The easiest way to make sure your information is up-to-date is to visit myflorida.com/accessflorida/ and create an account if you don’t have one already, said Dominguez.
If you lose coverage, what other options do you have?
If you’re no longer eligible for Medicaid, you might be eligible for other alternatives like Florida’s KidCare or perhaps you can qualify for Medicare, which kicks in when you are 65 or older. Some people might fall under “medically needed,” which requires a monthly deductible to be met before Medicaid kicks in, said Dominguez.
For people who fall into the access gap, they’ll have to rely on free clinics, federally qualified health centers and safety net programs at public hospitals to get care. These places often operate on a sliding fee scale to ensure everyone gets access to care, regardless of their ability to pay or if they have insurance or not.
Dominguez is encouraging anyone who has questions about their coverage or feels like they need help with the application to find organizations like Epilepsy Alliance Florida Navigation Program, which provide free enrollment help.
READ MORE: Thousands of Florida children could lose Medicaid coverage in months ahead, study says
This story was originally published January 21, 2023 5:30 AM.
