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.