HHSC Resumes Medicaid Eligibility Redeterminations as Continuous Coverage Requirement Ends

AUSTIN – The Texas Health and Human Services Commission is resuming eligibility redeterminations for approximately 5.9 million Medicaid recipients now that the federal Medicaid coverage requirement ended March 31. Federal guidance requires states to conduct a renewal determination for all Medicaid recipients over a 12-month period, and HHSC anticipates it will complete this process by May 2024. HHSC estimates Medicaid caseloads will return to levels in line with historical trends within the next two years.

“We urge Medicaid recipients to update their information and to be on the lookout for renewal notices,” said HHS Executive Commissioner Cecile Erwin Young. “We are committed to redetermining eligibility for our clients as quickly as possible and to continue services to those who still qualify.”

To handle the expected workload, HHSC has increased its eligibility workforce through various recruitment and retention efforts, including hiring temporary staff to assist with the workload, implementing merit pay and salary adjustments, promoting flexible work schedules, and streamlining training requirements. Since April 2022, HHSC has added 1,000 eligibility staff to its workforce.

HHSC is reminding all Medicaid recipients to respond to renewal packets or any requests for information in a timely manner to prevent potential gaps in coverage. HHSC is also urging all recipients to make sure their contact information is correct or up to date at Your Texas Benefits. Recipients who respond to renewal packets or requests for information from HHSC within 30 days will have their Medicaid coverage continue until the agency completes a redetermination to confirm if they are eligible to continue receiving benefits.

Medicaid recipients are being notified of the end of the continuous coverage requirement in a variety of ways. When it is time to renew, HHSC staff will inform recipients by mail or electronically. This month, HHSC will begin mailing all Medicaid renewal notices in a yellow envelope that says “Action Required” in red. HHSC will stagger Medicaid redeterminations over multiple months, prioritizing redeterminations for those most likely to no longer qualify for Medicaid. Renewal notices will also be sent electronically to recipients who have a Your Texas Benefits account and opted to go paperless.

In addition to mailed notices, HHSC is using social media posts, online banner messages, flyers, emails, and text messages to notify recipients about renewing their benefits. HHSC has supplied outreach tools to partner organizations or ambassadors to help spread the word about the end of continuous Medicaid coverage.

Medicaid recipients are encouraged to sign up and log into YourTexasbenefits.com and opt-in for electronic notices through their online account or the Your Texas Benefits mobile app. Recipients with a Your Texas Benefits account can click “Select Details” for their case. There will be a “Yes” in the Time to Renew column when it’s time to renew.

HHSC will also evaluate a recipient’s eligibility for other HHSC health care programs, such as the Children’s Health Insurance Program or Healthy Texas Women. Recipients will get a notice from HHSC if they are ineligible for Medicaid and are moved to a different health care program. Recipients’ applications are sent automatically to the federal Health Insurance Marketplace if they are not eligible for medical coverage through HHSC. To learn more or find someone to help with their application, they can visit HealthCare.gov or call 800-318-2596.

Medicaid recipients should report any changes, such as address, phone number, pregnancy, or household member changes at YourTexasBenefits.com, by mail, fax, calling 2-1-1 and selecting option 2, or visiting a local office or a community partner.

For Frequently Asked Questions about the end of continuous coverage, visit the HHSC webpage.