Missoula, MT (KGVO-AM News) - Now that the COVID-19 pandemic is officially over, Montana Medicaid and Healthy Montana Kids have both begun the process of redetermining the eligibility of Montana adults and children for these services.

KGVO News spoke to Jessie Counts, Human and Community Services Division Administrator for the Montana Department of Health and Human Services (DPHHS) about the ongoing process of redetermining eligibility for services that were continuously updated during the pandemic.

This Could be a Scary Time for Those on Medicaid or Healthy Montana Kids

“Since the beginning of the pandemic, so in about March of 2020, Medicaid Redeterminations were put on hold based on guidance from the federal government,” began Counts. “In January of this year, we were told that we were required to start Redeterminations for all Medicaid and Healthy Montana Kids members starting in April. So, this month we have started that redetermination process and we will look at all of our Montanans who are covered by Medicaid or Healthy Montana Kids over the next 10 months and do a redetermination on each case.”

Redetermining those eligible for these services might come as a shock to many, so DPHHS has created a process to appeal the decision to end that Medicaid or Healthy Montana Kids coverage.

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For Those who Disagree with the Redetermination there is an Appeal Process

“For individuals who we determine to be ineligible, there are a couple of different tabs for them,” she said. “If they believe that they should still be eligible, everyone has the right to request a fair hearing. That's really the proper process if they think that we did an incorrect redetermination. If their circumstances have changed since we've redetermined them to be ineligible and they believe they might now be eligible, they're able to reapply at any point.”

Counts said it’s vital that every adult and child that has been served during the pandemic update their current address with DPHHS with the most up to date information.

“The only other thing to share is that we've made a lot of efforts to try to make sure that we have clarity in the process, and that we've been able to contact all Montanans who are covered by Medicaid and Healthy Montana Kids to get this information out,” she said. “I would just encourage anyone who has had a change in address since March of 2020 to make sure that the agency has that change, so that we're able to get them the information that they need and avoid any gaps in coverage.”

Click on the Website Below for Accurate Information from DPHHS

Counts said there is a specific website where the best and most accurate information can be found.

“The Department (DPHHS) has created a specific webpage with information for both members and providers to try to explain the redetermination process and remove some of the mystery around what's happening,” she said. “That web page can be accessed if you go to the main department web page under ‘hot topics’. That is where you’ll find a link to the Medicaid updates.”

DPHHS must end coverage if individuals no longer qualify as a result of the change.

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