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Medicaid coverage set to end for many April 1. How will this impact South Carolinians?

Between January 2020 and September 2022, full-benefit membership for Medicaid in South Carolina increased from just over 1 million to approximately 1.29 million.

COLUMBIA, S.C. — With news that Medicaid coverage will end to many recipients beginning in April 2023, WLTX reached out to South Carolina Department of Health and Human Services (SCDHHS) to find out how that agency will handle notifications about eligibility within the state and how the federal action might impact South Carolinians.

The federal public health emergency (PHE) expanding Medicaid coverage was declared in January 2020, following the outbreak of COVID-19. Between January 2020 and September 2022, full-benefit membership for Medicaid in South Carolina increased from just over 1 million to approximately 1.29 million.

Jeff Leieritz, Director of Communications with SCDHHS, said in a statement the agency is required to check the eligibility status of Medicaid members annually to ensure those who are enrolled remain eligible for the program.

Over the course of the nearly three-year-long COVID-19 federal PHE, SCDHHS has worked with health care providers, community-based organizations and other stakeholders to develop a detailed plan to restart the typical annual review process. The agency has presented quarterly updates on its plan for the eventual resumption of annual eligibility reviews to its Medical Care Advisory Committee.

The Consolidated Appropriations Act, 2023, which was passed by Congress and signed into law by President Joe Biden on Dec. 23, 2022, provided state Medicaid agencies with a date of April 1, 2023, to resume the typical annual eligibility review process.

Leieritz continues, in resuming annual reviews, SCDHHS will first attempt to renew individuals’ Medicaid eligibility with information that is already available. If SCDHHS is able to verify continued eligibility this way, a Medicaid member will receive a “continuation of benefits” notice and will not receive an annual review form. If continued eligibility cannot be confirmed with information that is already available, the agency will notify the Medicaid member via mail and text message (if the agency has a mobile phone number on file) and will mail a form to be completed and returned. The agency is still awaiting specific guidance from the Centers for Medicare and Medicaid Services, but it anticipates distributing annual review forms and continuation of benefits notices to Medicaid members across a 12-month period beginning in early 2023.

The agency’s message to Medicaid members and the public is that it is really important that SCDHHS has updated contact information for its Healthy Connections Medicaid members. Members can update their contact information online via apply.scdhhs.gov, over the phone by calling (888) 549-0820 (Monday through Friday from 8 a.m. to 6 p.m.) or by visiting an SCDHHS county office (a list is available at www.scdhhs.gov/Getting-Started).

Individuals may check if to see if they qualify for federal assistance in purchasing health insurance through the Federal Marketplace at HealthCare.gov.

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