How West Virginia residents on Medicaid can maintain health insurance | Country and region

When COVID first upended West Virginia in the spring of 2020, the federal government took steps to ensure people had access to the food and health insurance they needed.

In some cases, the benefits increase. In others, such as Medicaid, state officials have been allowed to temporarily stop checking eligibility requirements. Since then, the insurance plan, designed to help low-income Americans, has allowed anyone who uses it to stay in the plan, regardless of family income.

However, many of these changes are now beginning to revert to the way they were. In early March, the federal Nutrition Assistance Program cut payments to pre-pandemic numbers. and starting April 1, the West Virginia Department of Health and Human Resources will begin verifying the income requirements of Medicaid users again.

Throughout April and the following months, many West Virginians who have insurance will have forms mailed to the physical address DHHR has for them. If they don’t respond to this letter quickly, they will likely lose their health insurance.

DHHR expects more than 100,000 West Virginians to lose Medicaid, which could lead to a huge jump in the state’s uninsured residents. According to Rhonda Rogombe, a health policy analyst at the West Virginia Center for Budget and Policy, many of the people expected to lose Medicaid are still eligible but have lost contact with the health department, often because they have moved and not have updated the health department.

But there are a number of resources to help people either keep Medicaid or switch to another affordable health insurance plan.

“We help you figure it all out,” said Jeremy Smith, program director of the state health insurance hotline. “We’re really just going through this whole process with people.”

Here’s how West Virginians using Medicaid can find out if they can stay on their plans and what next steps they should take.

Step 1: Make contact with DHHR

For the more than 600,000 West Virginians who use Medicaid, the first step to keeping their health insurance is making sure DHHR has their correct physical address. If people have changed addresses without updating the state health department, they will not receive the forms needed to keep Medicaid.

There are several ways to update contact information. For those who know their login details to the DHHR online portal, WV PATH can go there and click “login”. Then, before signing in, they need to click on “Manage your Optum GovID”.

After completing the prompts, people will be directed to a form where they can verify and update their contact information, including their physical address. If people prefer to make the change over the phone, they can call the DHHR Medicaid Customer Service Line at 1-877-716-1212.

People can also review and change their physical address at a local DHHR office, which can be found in all 55 counties of the state. Also, if they email [email protected] with their full name and current address, the department will update their files.

According to Smith, there are options for Medicaid consumers who are experiencing homelessness or do not have permanent mailing addresses. He said if someone calls his organization, West Virginia Navigator, his colleagues can find a group that will allow the person to receive mail in a physical building.

“Many of the coalitions that help homeless people have some tricks up their sleeves to advise people on what to do,” Smith said. “But [people using Medicaid] they definitely need to figure out what address they want to use.”

Step 2: Be on the lookout for DHHR documents

Starting in April, DHHR will begin mailing Medicaid forms to West Virginia residents who have insurance. Forms will be sent periodically and program users should expect to receive them anytime between April 2023 and April 2024.

The documents will ask for different information, including what someone’s salary is, and people must respond. DHHR will expect the individual to respond by the date specified in the documents; Smith said if people don’t respond by that date, they could be at risk of losing their health insurance.

“You’re not going to have unlimited time to give them all that stuff back,” he said.

Smith said most of the paperwork should only require information, and he doesn’t expect people will need to submit any other documentation in most cases. However, if people have questions about how to complete the forms, they can call and ask the Navigator program.

Even if people think they are no longer eligible for Medicaid, it is still important to complete the paperwork from DHHR. Rogombe said the forms are an important way to connect people who are no longer eligible for the program with other health insurance resources.

Step 3: Determine your health insurance options

Once someone sends back forms, DHHR will respond shortly as to whether or not they are still eligible for insurance. If they are still eligible, they will remain on Medicaid.

If someone is no longer eligible, Smith said they should call the Navigator program immediately to discuss other health insurance options. The federal government acted last year to keep insurance options for working-class Americans cheap — Smith said many people who no longer qualify for Medicaid can find plans for free or $10 a month. The bills would keep plan spending low at least through the end of 2025, according to the Kaiser Family Foundation.

People who are no longer eligible for Medicaid can also check with their employer to see if they provide a good insurance option. In some cases, when these plans are found to be too expensive, people may still be eligible for low-cost options from the federal government’s insurance marketplace. Smith said the Navigator program can advise people on the best option for them and their family and guide them through getting new insurance.

If people are looking for health insurance on their own, they should try to enroll before Medicaid coverage ends, a date that will be specified in the response sent by DHHR. Smith also noted that there are many options scam sites that do not comply with federal requirements. He says the only place people should shop for health insurance is the government’s HealthCare.gov website.

Useful resources

  • West Virginia residents can contact the state’s insurance hotline, West Virginia Navigator, at 304-356-5834 or at one of its four statewide offices. Funded by the federal government, the organization is staffed to ensure that current Medicaid users remain insured. They have people who speak Spanish and can find online translators for West Virginians who speak other languages.
  • At 6 p.m. on March 28, the West Virginia Budget and Policy Center will host a webinar on Facebook to walk people who use Medicaid through the means-testing process and answer questions.
  • DHHR has multiple hotlines to answer Medicaid-related questions. For questions about the online portal, the technical support number is 844-451-3515. For questions related to the insurance program, the customer service number is 877-716-1212.
  • The national website for health insurance is HealthCare.gov. It has resources to help you find out what plans are options for you and your family.

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