Continuous Medicaid Coverage Ended March 31, 2023
Your patients’ Medicaid coverage may be impacted by the end of continuous Medicaid coverage. Medicaid clients should ensure their information with the Health and Human Services Commission (HHSC) is accurate, so they get important updates about their coverage. HHSC will tell all Medicaid clients when it is time for them to renew their Medicaid coverage. They must respond to any renewals or information requests from HHSC.
Order FREE, professionally-printed, bilingual materials approved by HHSC to distribute/display in your office setting to help your patients understand how to renew their coverage. Community First will coordinate delivery at no charge.
How You Can Help Your Patients
Tell your patients to:
- Look for the notice saying “Action Required” in a yellow envelope from HHSC and respond quickly when they get it.
- Update their information as soon as possible, especially if their contact information has changed. They can do this by logging into their account at YourTexasBenefits.com or through the Your Texas Benefits mobile app.
- If they don’t have an account, they can create one on the website or mobile app. Or they can call 2-1-1 and choose option 2 to update their information.
Questions You Might Get Asked
Q: Why is this important? What happens if I don’t take any action?
A: You might lose your Medicaid coverage. That’s why it’s important for you to update your information with HHSC and respond quickly to any notices you get from them.
Q: Where can I get more information?
A: If you have any questions or need help with your Texas Medicaid coverage, call Member Services at the number on the back of your health plan member ID card. You can also call HHSC at 2-1-1 and choose option 2 (or call 1-877-541-7905).
Q: What happens if I don’t get a notice from HHSC?
A: If you’ve recently moved, HHSC may not have your most up-to-date contact information. They may have sent it to an old address. If you’re worried you might not have gotten any notices from HHSC because they
don’t have your current address or that there’s been a mistake, call 2-1-1 and choose option 2.
Questions You Might Have
Q: How do I verify my patient’s Medicaid coverage?
A: You can verify client eligibility for Medicaid through the Texas Medicaid & Healthcare Partnership’s (TMHP) TexMedConnect portal. You can also call 2-1-1. Press option 2 after the language prompt, and then option 2 again. Be prepared to provide your National Provider Identifier (NPI).
Q: If my patient is uninsured, where can they go for coverage?
A: If your patient was found ineligible for Medicaid, their case has been automatically sent to the federal marketplace to be considered for coverage options. For more information about this, visit Healthcare.gov. If they were disenrolled because they never responded to HHSC or didn’t complete their renewal application, they will not be transferred to the marketplace. This is because HHSC was not able to confirm their eligibility for Medicaid. In this case, they should submit their renewal for benefits.
Q: What is Prior Medicaid Coverage and how does someone apply?
A: When a person applies for Medicaid coverage through HHSC, they can apply for Medicaid benefits for up to three months prior to the month of application if they have unpaid medical bills in those three months. People can apply for prior Medicaid coverage by submitting Form H1113, Application for Prior Medicaid Coverage. Please refer patients to the Texas Works Handbook for more information.
What a patient can do:
- Verify their coverage. They can do this by going on the Your Texas Benefits app on their phone, going online to YourTexasBenefits.com, or by calling 2-1-1.
- Update their info. HHSC sends members renewal information by mail, or if they’ve gone paperless, by email or text.
- Complete renewal. Go to YourTexasBenefits.com or call 2-1-1. In some cases, they can resume coverage back to the original renewal date.