Medicaid Redetermination Process Has Begun: What Does This Mean For Your Practice?

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Medicaid Redetermination Process Has Begun: What Does This Mean For Your Practice?

Tuesday, April 11, 2023

The Medicaid redetermination process is designed to ensure that individuals who receive Medicaid benefits are still eligible for the program. The Michigan Department of Health and Human Services (MDHHS) has had a continuous coverage policy for Medicaid eligibility since January 1, 2020, because of the Coronavirus Disease 2019 (COVID-19) pandemic. This continuous coverage policy has ended, which means MDHHS has begun Medicaid redeterminations for the June 2023 cohort. During the redetermination process, individuals are required to provide updated information about their income, household size, and other factors that may affect their eligibility for Medicaid. MDHHS estimates that 761,931 individuals have been added to Medicaid since March 2020, which is when they stopped the redetermination process. MDHHS is projecting the average monthly redetermination will affect approximately 259,000 individuals.

MDHHS Medicaid eligibility renewal plan includes:

  • Sending eligibility renewal alert letters three months prior to the renewal month. (The June 2023 cohorts began receiving their letters in March 2023.)
  • Starting passive renewals two months prior to the renewal month. (Passive renewals began in April 2023 for the June 2023 cohorts.)
  • Mailing redetermination letters one month prior to the renewal month. (The June 2023 cohorts will receive their letter in May.)
  • Local offices will begin processing redeterminations the month of the renewal month. (The local offices will process June 2023 renewals in June 2023.)
  • The last date of coverage if someone is no longer eligible or did not return the packet is the last day of the renewal month. (The June 2023 renewals will lose coverage on June 30, 2023.)

This process will continue through May 2024. MDHHS has created an eligibility notification timeline webpage, which provides the dates for each renewal month.  

With more than 760,000 beneficiary redeterminations taking place in the next year, there is a potential of a large portion of Medicaid beneficiaries losing their eligibility. There are two groups of people who could lose their coverage: 

  1. The first group are beneficiaries who are still eligible but lose their eligibility for administrative reasons. They may have moved and did not receive the Medicaid redetermination letters or they may have received the letters but did not return the information. To help minimize this potential eligibility loss, practices should consider encouraging Medicaid patients to verify or update their contact information in MI Bridges. Beneficiaries can also call their local MDHHS office for help.  Additionally, practices should consider reminding Medicaid patients to open mail from MDHHS and complete and return the renewal documents. 
  2. The second group of individuals who will lose Medicaid coverage are patients whose income is too high. These patients may qualify for a Special Enrollment Period. If they have access to employer coverage, they can enroll in their employer’s benefit plan. Alternatively, they can purchase a policy through The Department of Insurance and Financial Services (DIFS) is building a webpage ( with specific Marketplace information related to the PHE. This will be a good resource for your patients who will lose Medicaid eligibility due to their income level. 

To help Medicaid beneficiaries, MDHHS is asking for stakeholders help and have created a stakeholder toolkit with branded flyers, which practices can use. Practices may also order outreach and education documents.

In addition to Medicaid redeterminations, MDHHS has begun the process of unwinding the Medicaid policies that are tied to the PHE. MDHHS created a COVID-19 Policy Crosswalk listing the policies and the policy action. MSMS will continue to monitor and update the membership on all the payer policy changes due to the end of the PHE.