Redetermination: Some Families Need to Re-Enroll in Medicaid

The COVID-19 Public Health Emergency officially ended on May 11, 2023. As a result, some children and families who have health insurance coverage through Medicaid could lose that coverage – without knowing it.

Partners For Kids, Nationwide Children’s Hospital, Dayton Children’s Hospital, Get Covered Ohio and many others across Ohio have created resources to ensure that people who are eligible for Medicaid coverage know that they may need to act to keep it.

Those resources are now available for others who want to help children and families requalify for their Medicaid coverage. 

What’s happening isn’t new; it’s the restart of a process that was paused because of COVID-19. The overall process is called “redetermination,” and it has traditionally happened every year. People covered by Medicaid must prove annually that they qualify.

During the three-plus years of the pandemic, though, the federal government provided extra Medicaid funding for states, and in turn, states have not removed people from Medicaid rolls. At the same time, the pandemic created economic hardships for some, making them newly eligible for this federal insurance program.

There were 25% more people covered by Medicaid at the height of the pandemic than there were before it started. Now everyone must prove that they are still eligible.

For many, redetermination happens automatically, using documentation that already exists. If a child or family has been deemed eligible for certain other benefit programs, for example, that can be used as proof that they are also eligible for Medicaid. In those cases, a child and family have to do nothing to keep this insurance coverage.

Everyone else in Ohio who is covered by Medicaid should receive a packet by mail, which they can use to prove eligibility. But a change of address may mean they won’t get the packet. So child- and family-centered organizations are trying to help.

Get Covered Ohio is led by the Ohio Association of Foodbanks, and it provides insurance navigators to help families not only with Medicaid, but with other insurance options as well. Partners For Kids, the accountable care organization from Nationwide Children’s Hospital and Dayton Children’s Hospital, has created a tool kit, digital signs, social media posts, flyers and other resources to help health care providers and others.