Some could soon lose Medicaid eligibility, but options are available

LINCOLN, Neb. (KLKN) — Requirements for Medicaid recipients are set to return to pre-pandemic status.

Normally, Medicaid recipients’ eligibility reviews are conducted annually to ensure recipients still meet the requirements.

Because of COVID-19, those reviews were paused when the government declared a public health emergency in March 2020.

This meant that anyone already on Medicaid was allowed to stay on even if there were changes in their life that would have made them ineligible before COVID hit.

Since the Biden administration declared that the public health emergency will end this May, Nebraska’s Medicaid eligibility reviews will return in March.

Kevin Bagley, director of Medicaid in the Nebraska Department of Health and Human Services, says nearly 390,000 people use Medicaid in Nebraska, and with eligibility checks returning, some may lose coverage.

“We’ve been able to estimate somewhere between 10 and 20% of those folks will lose eligibility over the course of the next 12 months as we go through this re-determination process.”

If you lose Medicaid, prescription coverage will be impacted, but there are avenues pharmacies can take to help you get your medicine.

“We’ll contact physicians and see if we can work together to find something less expensive but that still will take care of their needs,” said Dr. Monty Steele from RelyCare Pharmacy.

If your Medicaid re-determination renders you ineligible, Bagley wants you to know this:

“If we have someone that we find is no longer eligible, say their income has improved over the last several years, they’re in a better space, they no longer meet the income requirements to be eligible for Medicaid, what we will do is take their information and send it to the federal marketplace so that they can start the enrollment process if they choose to.”

For those coming out of Medicaid, the health insurance marketplace plans typically have subsidies that lower health insurance premium rates.