Health Plans Falter at Providing Medicaid Redetermination Info

[MM Curator Summary]: If we are counting on MCOs to get members to engage about the wind-down, we may be in for a disappointment.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


Medicaid beneficiaries with higher incomes were more likely to report receiving Medicaid redetermination and re-enrollment information compared to lower-income beneficiaries.


Source: Getty Images


By Victoria Bailey

May 18, 2022 – Member engagement may be lacking for Medicaid plans, as only 56 percent of beneficiaries reported receiving helpful information about Medicaid redetermination or re-enrollment, according to a survey conducted by The Harris Poll on behalf of the health action company Icario.

Redetermination is when states must identify who is no longer eligible for Medicaid coverage and reach out to beneficiaries to gather the information that substantiates eligibility.

Millions of beneficiaries are expected to lose Medicaid coverage once the public health emergency (PHE) ends.

The Harris Poll conducted the survey online and gathered responses from more than 600 Medicaid beneficiaries in April 2022.

The results revealed disparities between high- and low-income beneficiaries. Nearly 80 percent of individuals who had an annual household income of $75,000 or more said they received information on Medicaid redetermination within the last year, compared to 69 percent of beneficiaries with a yearly income of less than $75,000 who said the same.

Almost 30 percent of beneficiaries said they did not receive any information or did not know if they received information about Medicaid redetermination or re-enrollment. Without the proper information about re-enrolling or confirming eligibility, beneficiaries may risk losing healthcare coverage.

Medicaid enrollment has grown significantly during the two-plus years of the pandemic, so redetermination and re-enrollment is new ground for many people,” Sara Ratner, senior vice president of government markets and strategic initiatives at Icario, stated in the press release.

There is a category of people who are new to Medicaid and are not eligible for auto-enrollment, and they will experience difficulties if they’re not familiar with how redetermination works.”

Beneficiary participants also indicated their preferences about Medicaid medical benefits communications and how they have received this information in the past. 

Forty-four percent of beneficiaries reported they prefer that Medicaid email them benefits communications, while 43 percent said they had received information this way. 

The second-most preferred form of communication was paper mail. Four out of ten beneficiaries preferred receiving communication by paper mail. Just over half (56 percent) reported receiving paper mail from their plan in the past.  

Preference for paper mail was higher among individuals aged 55 and up (59 percent), with 73 percent of older adults reporting having received paper mail communications before.

But paper mail may not be the best form of communication for all beneficiaries.

“The good news is, for people who are older and tend to have more stable housing, paper mail makes sense,” Ratner said. “Meanwhile, younger people and those with less stable employment not only don’t prefer it, but they also don’t remember getting it.”

After email and paper mail, individuals preferred live phone calls (19 percent), text messages (17 percent), in-person support (13 percent), automated phone calls (eight percent), social media (seven percent), and informational videos (six percent).

Successful communication between Medicaid programs and their beneficiaries can help ensure that individuals are aware of any changes with their coverage or action they need to take to maintain coverage.

A research brief from Adaptation Health highlighted some of the challenges Louisiana Medicaid beneficiaries experienced regarding communication from their plans.

Beneficiaries received communications too late and too close to re-enrollment deadlines and some individuals reported being overwhelmed by the volume of communication. Additionally, beneficiaries expressed various ways that they prefer to receive information, suggesting that Medicaid plans should expand their communication methods.

Medicaid communication is especially critical now as beneficiaries consider how their coverage may change when the PHE eventually ends.

Congress implemented flexibilities that expanded Medicaid eligibility and ensured continuous Medicaid coverage during the PHE. These flexibilities led to Medicaid gaining more than 12 million enrollees during the pandemic.

If policymakers do not make these flexibilities permanent, Medicaid beneficiaries could lose their eligibility a month after the PHE emergency ends, as states will begin the dis-enrollment process.


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