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ALERT: Some Immigrants Who Were on Medicaid Lost Their Health Coverage January 1st

12 Jan, 2016

ALERT 

Some Immigrants Who Were on Medicaid Lost Their Health Coverage January 1st

Some immigrant adults who had Medicaid through the Marketplace lost their Medicaid coverage on January 1, 2016 and now have no health insurance.  Most of these individuals are eligible for the Essential Plan (EP).  They need help selecting an EP by January 31, 2016 to ensure they have coverage back to January 1, 2016 and going forward.  They also may need help with accessing urgently needed health services and bills.

Who Is Affected?

Immigrant adults who were in a Medicaid managed care (MMC) plan that does not offer a sister EP in their county AND who needed to enroll in the EP because of their immigration status.  Immigrant adults in the following MMC plans in the following counties are affected:

MMC Plan

Counties

CDPHP

Albany, Broome, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Tioga, Washington

Fidelis

Chemung, Clinton, Dutchess, Putnam, Tompkins

Today's Options

Cortland, Onondaga, Tompkins

Wellcare

Erie

BlueCross BlueShield of Western NY*

Allegany, Cattaraugus, Chautauqua, Erie, Orleans, Wyoming (*very few people on the Marketplace were enrolled in this plan)

How Can You Help?

  • Look out for immigrant adults who were enrolled in one of the above MMCs in the above counties.
  • Check their Marketplace accounts to see if they have coverage.
  • If they are not enrolled in EP, help them select and enroll in an EP!  They must select an EP plan by 1/31/16 for a 1/1/16 effective date.
  • If anybody who was not already enrolled in EP on January 1 has an urgent health care need that can’t wait until they get their EP plan card, contact Community Health Advocates (CHA) at 888-614-5400 or cha@cssny.org. Provide CHA with the AC number of the client, the name of the EP into which they are enrolled, and a statement about their urgent need for health services.  CHA will work with the Department of Health (DOH) on expediting the process.
  • If an affected person receives medical bills for services not covered in January because they were not yet in EP, also contact CHA.  CHA will work with the DOH to try to get the bills resolved.

Here is some additional background:  Some immigrants get state-only funded Medicaid under the Aliessa v. Novella decision.  Because the federal government helps pay for the Essential Plan, NY is transitioning most of these adult immigrants from Marketplace Medicaid to the Essential Plan.  The vast majority of these individuals were in Medicaid managed care plans that have a sister Essential Plan in the county.  However, some are in plans in counties that have no sister Essential Plan.  If they did not affirmatively pick a plan for January 1, then they will be without coverage until they get into an EP.  The EP, if selected by January 31, will be retroactive to January 1.  But some people who are just now selecting plans have an urgent need for health care and services.  Others may have gone to doctors before they joined EP who turned out not to be in their EP network.  CHA is bringing these cases to DOH for expedited info to bill EP and possible resolution of the medical bills. 


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