Having trouble viewing this email? View as Webpage
March 2023
Important Update on
Medicaid Eligibility Redetermination
The following information is for our patients enrolled in Medicaid health coverage, including Sunshine Health, Simpy Healthcare, CMS, Medicaid, and UHC Community.
(Note - This information does not apply to Tricare, which is not a Medicaid plan.)

Medicaid redetermination will resume in April 2023 and continue over the next 12 months.

Medicaid redetermination is a process used by the states to ensure that Medicaid members are still eligible for Medicaid coverage. States are required to periodically redetermine member eligibility and to disenroll those who no longer meet the eligibility guidelines.

Redetermination has not occurred since the Public Health Emergency related to COVID-19 was declared. Enrollees have been protected by a continuous coverage requirement in the emergency declaration.

When redetermination resumes in April, Medicaid enrollees will be required to verify eligibility or risk losing Medicaid coverage. In Florida, the Department of Children and Families determines eligibility for Medicaid.

See below for what to expect, and steps you can take to prepare.
PLEASE NOTE: Pediatric Health Care Alliance does not have any role in the Medicaid eligibility process. We are sharing this information to help increase education and awareness for our patients about these upcoming changes.

If you have questions about your Medicaid renewal or eligibility, please contact the Member Services number listed on your insurance card. 
1. Update Your Contact Information in MyACCESS
To make sure you can receive all communications about Medicaid redetermination and eligibility, update your contact information in MyACCESS today.

You can also check your redetermination date through MyACCESS.

Please use the link below and click on "MyACCESS Login".
2. Look for Your Notice of Eligibility
A notice of eligibility will be sent to Medicaid enrollees 45 days before their redetermination date.

You don’t want to miss this critical piece of mail.

Watch for the envelope with the yellow stripe, it has your Medicaid renewal notice.

See image below for sample envelope with the stripe. 
3. What You Need to Know
  • Redeterminations will take place over a 12-month period, Some enrollees may receive the renewal notice very soon, while others may not receive the notice for several months or longer.

  • The Department of Children and Families and the individual Medicaid health plans will be sending communications to enrollees throughout this process.