Vermont, other states to resume checking Medicaid eligibility; recipients need to make sure info is updated

WATERBURY — Vermonters on Medicaid are being told they need to make sure their contact information is up-to-date, since the state will resume checking if people are qualified for the program.

The rules and criteria around Medicaid eligibility have not changed, said Ginger Irish, director of communications and legislative affairs at the Department of Vermont Health Access. What has changed is the federal government is now telling states they have to resume annually checking whether their citizens on Medicaid still qualify.

"It's really important to understand that this is a federal change that's happening," she said. "During the pandemic, the federal government told states that they could pause checking whether people could still qualify for Medicaid."

Normally, states check eligibility on an annual basis.

"Because the pandemic was happening, the federal government said, 'Hey, we really don't want people to lose their health insurance on top of a global pandemic,' so state's essentially paused this process where every year they would check if this person still qualifies for Medicaid," said Irish.

In December, the federal government told the states that come April they'd have to start checking Medicaid eligibility once again

"Just to be clear, they didn't say benefits are changing, whether you qualify or not is not changing, they're just telling states to start to check again," said Irish.

She said it would be nice if the state could identify a small group of Medicaid recipients who really need to make sure their information is up-to-date, but after three years of the verification process being paused, every Vermonter on Medicaid needs to reach out to Vermont Health Connect and verify their address, email address, and phone number.

People can do this by going online at VermontHealthConnect.gov or by calling 1-855-899-9600.

Irish said there's no way to tell how many people might no longer qualify.

Mike Fisher, chief health care advocate at the Office of the Health Care Advocate with Vermont Legal Aid, said that about 200,000 Vermonters will need to go through this Medicaid verification process. He likewise said there's no way to accurately say how many of those folks might no longer qualify for Medicaid.

"For three years, they haven't been doing this process," he said. "This population of people doesn't stay put, and so while I think Medicaid is doing what it can, I would not be surprised one bit if there aren't a healthy number of people who have moved and Medicaid just doesn't know where to send the notices to."

Fisher said people with questions should contact the Department of Vermont Health Access, but if they have any problems or issues, they should contact his office either online at vtlawhelp.org/health or by calling 800-917-7787.

He said this is a big effort and that the federal government had laid out how and when it wants things done. He's looked over the current plan and favors it, but how well it goes depends on how many people respond to the notices they're sent and how many make sure they get those notices.

"I think the real thing that we need people to understand is that they're going to have to respond, they're going to have to contact Medicaid, or if they need to contact my office for support, to make sure they get the programs they're eligible for," he said.

According to Irish, many people who qualify for Medicaid do so because of their income levels. Major life events, such as getting or losing a job, getting married or divorced, can impact one's eligibility.

She and Fisher both said there is an effort to get this message out to as many Medicaid recipients as possible.

"We are here to guide Vermonters through this process," stated Jenney Samuelson, Agency of Human Services secretary, in a release. "It's really important for Vermonters to make sure we have the right information to contact them. Vermont is proud to have among the highest insured rates in the nation at 97%. We want to make sure Vermonters on Medicaid have the information they need to take action and stay insured."

Those who do end up no longer qualifying for Medicaid have some options, stated Andrea De La Bruere, commissioner of the Department of Vermont Health Access, in the same release. "We want Vermonters to know that there is money available to help them afford health plans on Vermont's health insurance marketplace, Vermont Health Connect."

keith.whitcomb @rutlandherald.com