Wyoming Medicaid renewals continue across state

Wyoming Medicaid’s renewal process, which was restarted earlier this year to review client eligibility, has reached a key stage, according to the Wyoming Department of Health (WDH).

Medicaid is a joint federal-state insurance program that pays for the medical and long-term care of qualified low-income and medically needy individuals and families. In 2020, the federal government stopped Medicaid and Kid Care CHIP eligibility reviews in all states in exchange for temporarily increased federal funding.

States are now required to return to normal renewal procedures and the increased federal funding is ending.

The department recommends beneficiaries check whether Wyoming Medicaid or Kid Care CHIP has current contact information renewal so notices are not missed. For those who have received packets, it is critical for forms to be completed and submitted as required to avoid loss of coverage.

WDH has been reporting the state’s renewal status to the federal government since April. Through the end of July, coverage was renewed for just over 9000 beneficiaries.

During the same period, coverage was ended for just over 600 clients for reasons such as reaching adulthood so no longer eligible for coverage as a child, increased income, a health status change or a move to another state.

Wyoming numbers are also now available for a category known as “procedural terminations.” This includes those who did not return renewal forms or respond to questions from WDH about their own coverage or the coverage of a family member.

Through the end of July, coverage was ended for more than 10,100 Wyoming Medicaid or Kid Care CHIP clients for procedural reasons.

“While the number for procedural terminations may seem high, there are important considerations,” said Lee Grossman, state Medicaid agent and Division of Healthcare Financing senior administrator with WDH. “The figure represents a total since April and is not a monthly number.”

“We believe many individuals who did not return forms may have realized they or their family member were no longer eligible. At the same time, we are concerned about enrollees who did not complete the renewal process but who may still be eligible for services. We absolutely want them to remain covered,” Grossman said.

Individuals who lose coverage for procedural reasons may provide required information for up to 90 days after coverage ended. If found to still be eligible, coverage can be backdated for up to 90 days.

About three-quarters of the procedural terminations to date involve children, which has always been Wyoming Medicaid’s largest enrollment group.

Grossman noted family members, providers and case managers often play important roles with beneficiaries, such as children or those with disabilities, who may be unable to manage the renewal process themselves.

“We’re asking them to be aware of the renewal process as we return to business as usual. Please check on those addresses and please do not ignore notices from Wyoming Medicaid or Kid Care CHIP,” he said.

Not all clients receive renewal notices at the same time, with a portion sent each month. The effort will continue annually, as required by federal regulations.

Enrollees can update their contact information or go through the renewal process online if it’s their turn at www.wesystem.wyo.gov or by calling 1-855-294-2127.

A low income does not automatically qualify people for Wyoming Medicaid. People must also fall into certain categories based on age or health status.

Wyoming Medicaid includes several “waiver” programs designed for eligible participants who prefer to get long-term care services and supports in their home or community, rather than in an institutional setting. The renewal process applies to waiver participants.

“As we prepared to restart our renewal process well over a year ago, it was estimated roughly 10,000 to 15,000 beneficiaries would lose coverage,” Grossman said. “Our enrollment continued to increase past that point in time, which will likely result in a higher overall number of closures through the year.”

“Average monthly enrollment in Wyoming Medicaid before the pandemic was around 55,000,” Grossman said. “Because eligibility could not be reviewed until recently, this year it’s reached a historic high of about 87,000. It is not unreasonable to expect enrollment to return much closer to the range we saw before the pandemic.”

“Renewals help ensure state and federal resources are used as intended,” Grossman said.

It’s expected many clients found to be ineligible will qualify for subsidized insurance coverage through the federal exchange. Some children may also be moved to the Kid Care CHIP program, which has higher income guidelines.