Medicaid Redetermination: What you need to know

On April 1, Georgia began the annual Medicaid redetermination process for each Medicaid enrollee to ensure that they are still eligible for Medicaid benefits. During this process, some enrollees will lose eligibility and as a result, lose their Medicaid coverage.

Individuals who lose Medicaid coverage:

  • Prior to July 10, 2023 will have until September 8, 2023 to enroll in another plan.
  • On or after July 10, 2023 will have 60 days to enroll in another plan.

Coverage options

For those individuals who no longer qualify for Medicaid, they still have choices for quality, affordable coverage. Coverage options may include:

  • Employer-sponsored health plans
    • Once Medicaid coverage terminates, if employer coverage is an option, the individual will have 60 days to enroll in alternate coverage.
  • Individual ACA plans through the Federal Marketplace or directly through carriers, like Kaiser Permanente
    • Financial assistance could be available to those enrolling through the Federal Marketplaces, depending on their income. In 2023, it is estimated that 90% of marketplace consumers will receive financial assistance through Advanced Premium Tax Credits (APTC), and on average, these consumers saved over $800 in premiums per year.1
    • All of Kaiser Permanente’s Individual and Family plans cover things like prescription drugs, doctor visits, urgent care, hospital visits, and more.
    • Kaiser Permanente Medicaid patients who transition to a Kaiser Permanente plan can continue seeing their Kaiser Permanente doctors, for a seamless care experience regardless of their coverage type.
  • Medicare for those over 65

How employers can support employees during the redetermination process

Employers play an important role in helping their employees navigate the complex world of health care coverage.

Employers can support their employees by:

  1. Communicating details around the redetermination process and sharing options to stay covered.
  2. Helping them prepare for the special enrollment period, that’s triggered by the loss of Medicaid coverage.

Below are resources you can share with your employees who have lost Medicaid coverage: