How to Renew Medicaid Benefits

Medicaid requires all beneficiaries to perform an annual Medicaid renewal. This renewal process verifies that an individual is still eligible for benefits. As such, recipients must provide updated information.

This can include information about an applicant such as age, income, citizenship status and disability. Program participants receive a packet that alerts them when it is time to recertify. Applicants may renew Medicaid online, by mail or telephone. Failing to recertify could cause program participants to lose their health coverage.

Individuals who become eligible for Medicare since their last renewal are also encouraged to renew, as they may have dual eligibility for both programs. Current recipients can read below for important information about Medicaid renewal and the methods for submitting a Medicaid renewal form to continue receiving benefits.

The Importance of Performing a Medicaid Renewal

Medicaid recipients must renew benefits annually to maintain their health coverage. It is important to complete a Medicaid renewal form because the program is a needs-based program that qualifies individuals based on income. As such, recipients must prove they are still eligible for the program. Individuals must submit information about their age, income, disability status and citizenship status at each renewal. The program uses this information to evaluate if the individual still meets the criteria to receive benefits.

Related Article: Medicaid Eligibility

Medicaid must perform this review to ensure the program is not spending money unnecessarily on individuals who do not qualify. When the program pays for unnecessary care, it limits funding for those who do qualify.  Therefore, it is crucial for applicants to be honest about any information submitted when performing Medicaid recertification so that they and the others who are eligible continue to receive the coverage needed for their healthcare.

When am I required to perform a Medicaid renewal?

Beneficiaries must do a Medicaid renewal every year. The timeline varies per state and individuals will receive a renewal notice in the mail when it is time to recertify eligibility. The packet contains the Medicaid recertification form as well as instructions for completing the form. Additionally, the packet outlines alternative methods to renew such as online, in-person or by telephone. Each state has guidelines on how long an individual to complete the recertification. The timeframe is usually between 60-90 days.

In most states, Medicaid does not forward mail. As such, beneficiaries must notify their state agency in the event their address changes. Failing to update their mailing address could cause the individual to miss important information from Medicaid. As a result, they could lose their benefits without realizing it.

An individual must still complete the Medicaid recertification process even if they become eligible for Medicare since the last renewal. Some individuals may qualify for Medicaid even if they receive Medicare benefits.

What are the requirements to complete a Medicaid renewal?

When completing the Medicaid recertification process, individuals must qualify for the program in much the same manner as when they applied. The program does a review of each applicant’s information on the Medicaid renewal form to decide on eligibility. In general, applicants must meet the following requirements:

  • Income at or below the Modified Adjusted Gross Income (MAGI) for their area
  • Citizen of the U.S. or qualified immigration status
  • Resident of the state they are receiving aid

In some cases, individuals qualify if they have children, are pregnant or have a qualifying disability. CHIP benefits allow children and some pregnant women to get benefits even if the rest of the family is not able to get standard Medicaid benefits.

How to Complete a Medicaid Renewal Form

The Medicaid renewal form collects extensive information about the individual’s income and household. Applicants must complete the Medicaid recertification form in its entirety. Otherwise, they may face delays in renewing the benefits. To complete the form, program participants must provide the following Information:

  • Name and address of the applicant
  • Names of all members of the household who file taxes
  • The Social Security Number for each person who currently receives Medicaid
  • Name and Social Security Number of new members of the household who need coverage
  • Name of employers and amount of pay
  • Information for all sources of income

Related Article: How to Apply to Medicaid

Individuals may designate a representative to help them complete the application. They may do so by completing the appropriate form provided in the Medicaid renewal packet.

How to Renew Medicaid Online

Rather than only allowing them to renew Medicaid by phone, mail or in person, some states may permit Medicaid participants to complete a Medicaid renewal online. The renewal packet outlines procedures to utilize this option. To renew online, individuals must use the login information provided by their state agency to access the website. Individuals may need to provide their Social Security Number when logging in to perform the recertification online. The individual will also need a valid email address to receive confirmation that the recertification was successfully submitted.

How to Perform a Medicaid Renewal by Phone

Many states offer the option to new Medicaid by phone. Each state agency has a specific procedure and telephone number to perform a Medicaid renewal by phone. When the renewal packet arrives in the mail, beneficiaries should read the packet carefully to learn all renewal options. To renew by phone, they must call the telephone number provided in their renewal packet. When calling, applicants must be ready to provide the following information:

  • Name and address information for each applicant
  • Name and age of everyone in the household
  • Citizenship status
  • Income

If the agency requires further information for the Medicaid renewal, they will provide the applicant with procedures for submitting the additional documentation.

How to Perform a Medicaid Recertification by Mail

Beneficiaries may perform a Medicaid recertification by mail in many states. Their welcome packet contains the Medicaid renewal form and outlines the procedures for renewing by mail. The beneficiary must complete the form in its entirety by following the instructions noted above. Failing to complete the form properly could delay renewing their coverage.

Performing a Medicaid Renewal in Person

In some states, beneficiaries may complete their Medicaid recertification form in person. The applicant’s Medicaid renewal packet outlines the procedures for performing the recertification in person. Beneficiaries should complete the application from the renewal packet using the instructions above before visiting their local Medicaid agency. Individuals must take documents such as paystubs, identification, cards and citizenship documents to the office along with their application. It is important for applicants to provide this information when completing their recertification to avoid delays in renewing their benefits.

What happens if I do not perform a Medicaid recertification?

Beneficiaries must complete the Medicaid renewal process or they may lose their benefits. Additionally, they must submit the Medicaid recertification form within the time allotted by their state agency to continue to receive coverage. If an individual does not recertify or does not recertify in time, they must reapply. They must complete a new application and complete the entire verification process from the beginning to regain their benefits.

What happens if I perform a Medicaid Recertification but no longer qualify for the program?

In some cases, after completing a Medicaid renewal, beneficiaries may no longer qualify for the program. In such cases, they may appeal their Medicaid recertification decision using their state Medicaid appeal process. To appeal, individuals should contact their state agency for the form. During an appeal, individuals may present their case as to why they should continue to receive benefits. Beneficiaries should note, that the appeals process is not a reconsideration of benefits. It is a process to request that a person’s benefits continue if they have been terminated during the recertification

Individuals must file their appeal within the time outlined by their state Medicaid agency. During the appeal, the beneficiary meets with an appeals officer who listens to the person’s argument that benefits should continue. Individuals may represent themselves or hire an attorney to represent them at an appeal. Beneficiaries may present evidence during the case and may bring witnesses that may help support their claim. After the hearing, the hearing officer makes a decision based on the evidence presented. It may take time for the officer to review all information, and as such, beneficiaries may not get a Medicaid renewal decision immediately after the hearing. The officer can provide more details on the timeframe for returning their decision.

Related Article: Medicaid Related Programs


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