Dear Avisery Members, 

Illinois Department of Health and Family Services (HFS) announced that in preparation for the Medicaid Unwinding Period beginning April 1, 2023, they are transitioning ACA Adult Medicaid beneficiaries who turned 65 and/or enrolled in Medicare at any point during the pandemic to the AABD Medicaid program. Beneficiaries will not lose their Medicaid coverage due to this transition. HFS sent out notices to approximately 55,000 affected beneficiaries during the week of February 20, 2023. 

BACKGROUND 

Since March 2020, Illinois has not terminated beneficiaries’ Medicaid benefits due to the requirement in the 2020 Families First Coronavirus Relief Act (FFCRA) that state Medicaid programs provide “continuous eligibility” for Medicaid members during the COVID-19 Public Health Emergency. However, recent legislation in late 2022 separated the Medicaid continuous eligibility provision from the Public Health Emergency declaration. States will now begin “unwinding” from Medicaid continuous coverage starting April 1, 2023. As a result, Illinois has decided to start sending redetermination notices on May 1, 2023. (For more information on HFS’ plans for the unwinding, click here.) 

HFS is preparing for the start of Medicaid redeterminations by recategorizing any beneficiary currently in ACA Medicaid that turned 65 or who has enrolled in Medicare since March 2020 to AABD Medicaid. ACA Medicaid is the Medicaid category for adults who are 19-64, while AABD Medicaid is the Medicaid category for adults 65+ or enrolled in Medicare. Because the two categories have different income and asset limits, moving these individuals into the correct category will allow for the proper criteria to be applied when the beneficiary goes through their first redetermination after the Medicaid continuous eligibility ends. Additionally, HFS designated some of the individuals as being in "met spenddown" status based on their income.

ACTION STEPS 

If your client has received an AABD Medicaid transition notice, here are three steps your client may take to enroll in Medicare Savings Program (MSP) and/or Medicare. 

If they have Medicare: HFS has informed us that this transition to AABD Medicaid was not associated with a screening for MSP. Avisery recommends checking whether any of your clients newly placed in AABD Medicaid are already receiving MSP.

If they do not have Medicare and have 40+ work credits through Social Security: If your client does not have Medicare and has the 40+ work credits that qualify them for premium-free Part A, you can enroll them into Part A at any time of the year. To enroll them into Part B, the client can use the state buy-in program by applying for MSP to facilitate enrollment into Part B. In the MSP application, use the language “Please use this application to facilitate enrollment into Medicare Part B” in the comment box.   

If they do not have Medicare and do not have the 40+ work credits through Social Security: If the client has less than 40+ work credits, they will not qualify for premium-free Part A. However, they can still enroll in Medicare using Part A Conditional Enrollment until March 31, 2023. Part A Conditional Enrollment allows the client to enroll in Medicare Part A only if the state finds them eligible for assistance paying the premium. To learn more about this process, click here.   

Please note that if your client loses their Medicaid coverage after their redetermination date and is eligible for Medicare but not enrolled, they can use Medicare’s new Special Enrollment Period. This enrollment period lasts three months after the beneficiary is notified that they are no longer eligible for Medicaid. Meeting spenddown is not considered a loss of Medicaid coverage. 

Please feel free to contact Avisery at avisery@ageoptions.org if you have any questions or concerns regarding the end of the Medicaid Continuous Eligibility.