Approximately 12,745 Minnesotans – mostly children – will see their Medicaid coverage restored by the end of November under recent Centers for Medicare & Medicaid Services (CMS) guidance. The move will alleviate financial pressures on these low-income families and ensure access to preventive medicine, vaccinations, prescription drugs and mental health services.

The Minnesotans being reinstated previously had Medical Assistance coverage but were disenrolled for not completing renewal forms or returning requested information for July, August or September renewals. However, their coverage could have renewed automatically – without returning paperwork – under the recent CMS clarifications.

To help ease the workload on county and tribal eligibility workers, DHS workers will manually reinstate coverage for these impacted enrollees by Nov. 30 and mail them reinstatement letters (example of reinstatement letter that will be mailed). The letters will include information about what to do if they were charged for health care services that would otherwise have been covered while they were disenrolled. 

Enrollees who lost coverage and whose coverage is reinstated may be eligible for payment of services retroactively. Enrollees should share their reinstatement notice with their health care providers for purposes of billing Medical Assistance. The service must be covered by Medical Assistance for retroactive payment.

DHS will work with county and tribal eligibility workers to manually prevent similar coverage losses for individual Medical Assistance enrollees due to renew in October, November and December who could have automatically renewed. This will ensure an estimated 54,000 Minnesotans keep their health insurance. All other enrollees scheduled to renew between Oct. 1 and Dec. 31 will have up to three additional months to complete the renewal process. This affords time for additional outreach to encourage them to return their renewal paperwork and gives workers time to process their manual renewals. 

IT system changes are underway to solve similar issues with automatic renewals. Until the changes are in place for June renewals, for enrollees who renew in January to May, we will identify households with one or more enrollees who likely should have been individually auto renewed and these households will be manually renewed. If patterns of enrollment are consistent from January to May, this will help approximately 121,000 Minnesotans avoid a gap in health care coverage.

Background

Like all states, Minnesota is required to automatically renew coverage for Medicaid enrollees when their eligibility can be verified electronically through trusted data sources. This allows enrollees to keep their insurance without needing to complete renewal paperwork. 

Minnesota and 29 other states perform these automatic renewals for households rather than individuals in the household. If a household member on Medicaid cannot be renewed automatically, then no household members are automatically renewed, even if some individual household members could be. As a result, eligible individual enrollees may potentially lose their coverage for problems with their renewal paperwork, including if the paperwork was never received or never completed. 

CMS is now requiring states to conduct these automatic renewals for each individual enrollee in a household to prevent closing coverage for eligible people who fail to complete their renewal paperwork. The guidance is tied to millions of dollars in federal funding.

DHS has submitted a mitigation plan to CMS that explains how Minnesota will address noncompliance until a permanent system change fixes the issue. Follow-up conversations with CMS on this plan have been productive and should result in approval from CMS. 

Enrollee outreach 

Despite these changes resulting from the CMS-required mitigation plan, messages to enrollees about renewals remain clear and consistent:

Follow these steps to avoid gaps in coverage:  

• Make sure you update your address if you’ve moved in the last four years.
• Watch your mail for renewal information.
  • Your notification might say your coverage has been automatically renewed.
  • It may also have instructions for returning paperwork.
  • It may say that coverage has been reinstated. 
• Return paperwork as soon as possible.
• Learn more about renewals at mn.gov/dhs/renewmycoverage.

Together, we’ve conducted unprecedented outreach with enrollees as renewals have resumed. Please continue to spread the word about renewals with Minnesotans using the materials in the communications toolkit.

Good news: Automatic renewal rates increasing

Keeping more eligible Minnesotans covered through automated processes reduces the burden on families to complete paperwork and drops the amount of time counties and tribes need to commit to processing paperwork. There are indications of success with the work to increase the automatic renewal rate.

• The auto renewal rate for individuals in January is 28% – a substantial increase from November and December rates, which were below 20%.
• The auto renewal rate for cases in January is 31% – up from November and December rates, which averaged around 25%.
• Auto-renewal rates will differ depending on whether they are calculated based on total cases or total individuals due for renewal. They may also vary if calculated for a specific system or program. Historically, auto-renew rates were typically reported by case. However, as systems are updated to reflect renewals based on individuals, it will become increasingly important to use the auto-renewal rate by individual for comparison.  

Thank you

The efforts to renew Medical Assistance and MinnesotaCare enrollees when pandemic-era protections ended has been tremendous. Thank you for all you’re doing to ensure access to health care and keeping eligible Minnesotans insured.