Medicaid beneficiary renewal process changes due to the Affordable Care Act
The Affordable Care Act (ACA) includes changes to the process for renewing a person’s Medicaid benefits, which take effect Jan. 1, 2015. Here are some important facts to know:
Beneficiaries no longer are required to visit a regional office or outstation in Mississippi in person to renew their benefits.
Beneficiaries can go through the renewal process by phone, fax, email or in person if they wish. Beneficiaries are welcome to call toll-free 1-800-421-2408, or visit the Division of Medicaid (DOM) website at medicaid.ms.gov to find the number for the regional office nearest to them.
Renewal Process
For each approved Medicaid application, the household or individual is assigned a review due date for the following year. These administrative reviews are performed to verify family income in order to continue Medicaid or Children’s Health Insurance Program (CHIP) eligibility.
At renewal time, the Division of Medicaid first attempts to renew cases automatically.
During that review, a specialist reviews the case and checks available electronic sources for the types of income reported by the family to determine if eligibility can be continued automatically.
If renewal cannot be completed automatically, then the Division of Medicaid attempts to contact the beneficiary and a pre-populated renewal form is sent to the address on file.
The form requires a response from the household or individual within 30 days. The renewal form provides the information the agency used to make the previous eligibility decision. The family is asked to review the form, update it with changed or new information and return it to the agency.
Timeframe
- The family is allowed 30 days to return the form. If there is no response near the end of the 30-day period, a courtesy phone call is attempted by the caseworker to provide any assistance needed.
- If a closure notice has to be issued, 15 days advance notice of closure is given to allow the family time to comply before the case closes.
- If a case is closed due to non-response to renewal, there is a 90-day reinstatement period with no loss of benefits if the information is provided within that 90-day timeframe.
