Medicaid eligibility review process beginning in Georgia | Everything you need to know

ATLANTA — Georgia, along with every other state, must review the eligibility of its Medicaid recipients due to changes in federal law ahead of the end of the COVID-19 public health emergency.

A federal policy under the emergency had frozen Medicaid eligibility in place - guaranteeing that people who were on the program when the pandemic began would continue receiving it, regardless of how their eligibility changed.

Over the next year, though, the states will have to determine who still is eligible and who is no longer qualifies. Congress passed a spending bill in December requiring this process.

RELATED: Notices begin going out to Georgians about Medicaid eligibility reviews, advocates say

As the process now begins - 11Alive's Tracey Amick-Peer reported Monday that notices have begun going out informing people their eligibility will be reviewed - state officials at the Georgia Department of Human Services provided some figures outlining how it will work.

As a reminder, if you're concerned about your coverage the most important thing you can do is visit the Georgia Gateway portal here and make sure your information is up to date

Medicaid unwinding things to know in Georgia

First, most importantly, what you can do:

• Update your information or make sure it is currently update to date through the state DHS portal at gateway.ga.gov.
• Through that portal, you can also check the month your review will be happening.
• If you get denied coverage renewal for failing to submit information, state officials stress you still can submit your documents within 90 days of the redetermination date.
• State officials also direct people to staycovered.ga.gov for further resources and help with questions about the process.

Here's a state explanation of how you might receive notices: "Forty-five days before a Medicaid or PeachCare for Kids member’s redetermination deadline, DHS will send an official letter or email letting the member know that their redetermination process has begun. The letter will explain that the member’s redetermination window has begun, and that the member may have to submit documentation like pay stubs or other materials to complete their renewal. If DHS has not heard from or received documentation from the member after a month, the member will get a reminder letter or email that their coverage eligibility decision is coming soon. It will tell them to prepare and submit any requested documentation as soon as possible to avoid a potential gap in coverage."

If your coverage renewal is denied:

• You will receive a letter notifying you of the decision and explaining the reason why.
• As noted above, if you are given the reason of "failed to submit" documents, you still can submit within 90 days of your redetermination date.
•  If you have aged out of the PeachCare for Kids program or are no longer eligible for Medicaid, state officials say you will be referred to the Federally Facilitated Marketplace for alternative coverage options.

Other things to know about the process:

• Reminders about coverage reviews began going out in letters and emails on May 12. They remind recipients to be prepared to submit any requested documentation as soon as possible, and text message reminders go out 30 days before the deadline. Another text will go out 10 days before the deadline.
• The state says 12,526 renewal determinations are due by the end of May. 6,509 reminder letters and emails first went out last Friday, May 12.
• Of those, 5,152 people were automatically renewed. The other 7,374 people were asked to submit further documentation to verify their eligibility.
• Meanwhile, through the state's work on other aid programs like SNAP and TANF, 66,127 Medicaid recipients were determined to be eligible for renewal.
• As the process ramps up, about 250,000 recipients will be renewed per month. State officials said next month that 227,595 recipients would be reviewed.
• “DHS and DCH (Department of Community Health) are working hard to make sure that eligible members are aware of redetermination and can complete the process to continue receiving Medicaid or PeachCare for Kids coverage. All Medicaid or PeachCare for Kids members should visit Gateway now to confirm their individual redetermination month and learn how to prepare. You should also continue to keep your contact information up to date so we can reach you with notices about your coverage," DHS Commissioner Candice Broce said in a statement.