Throughout the Coronavirus Public Health Emergency (PHE), the federal government issued a mandate to states that required “maintenance of effort”, meaning that those enrolled in the state’s Medicaid program could not be disenrolled. Now that the PHE is expiring, the State of New Mexico Human Services Department (HSD) will begin asking our members, and your patients, to go through the process of “redetermination” to maintain their Medicaid eligibility. They must provide their latest financial and demographic information to keep their Medicaid benefits. Because the PHE has lasted over two years, there will be thousands of Medicaid enrollees in the three participating Medicaid Managed Care Organizations (MCOs) and in the fee-for-service program who will be dropped from Medicaid coverage if they do not take the necessary steps to re-enroll.
HSD and Blue Cross Blue Shield of New Mexico (BCBSNM) are sending Medicaid enrollees letters, doing outreach phone calls, and sending text messages to inform them of these changes and that annual redeterminations are once again a requirement for on-going Medicaid eligibility.
Please help HSD, BCBSNM and your patients get renewed so that they can preserve continuity of care.
Below are questions and responses that will help you guide your patients:
- If patients ask us for information about renewing their benefits so they stay eligible for services, what do we tell them?
- Can my patients renew their coverage by mail?
- What is the telephone number if they wish to get information by phone?
- Do my patients need to choose a health plan when they update their income and address/phone number information?
- If their household income has changed, will they go without coverage?
The best and most timely way for them to re-enroll is to direct them to the following website – www.yes.state.nm.us to renew their Medicaid and other assistance benefits. This will avoid waiting in a telephone queue with HSD that will be extremely busy over the next several months.
Yes! HSD will be sending them packets and if they fill it out and return it in the envelope provided, HSD can process their paperwork and get them re-enrolled. The theme HSD is using for this purpose is “Back on Track,” so they should look for this logo on their mail.
If they still qualify for Medicaid, they will stay in the same health plan, which will minimize disruption.
If they want to change to a different MCO, they can do so during this renewal period.
If they are no longer eligible for Medicaid due to household income, HSD will inform them of that fact. At the same time, they will send their information via secure file to the New Mexico Health Insurance Exchange (Exchange) who will work with them to find another health plan. Once notified that their information is with the Exchange, they will have 60 days to choose a new plan.
All three of the Medicaid MCOs have health plans on the Exchange. If your patients want to continue with the same providers they have had under Medicaid, advise them to stay with the same insurance carrier.
Thank you for helping keep New Mexicans covered for services and benefits. We appreciate and value your assistance.