Understanding the New Medicaid Changes

A new bill recently signed into law, referred to by some as the “Big Beautiful Bill”, introduces several significant changes to Medicaid.  These adjustments may affect how older adults access and maintain their Medicaid benefits.  If you or a loved one rely on Medicaid, it is important to understand what is changing and how it may impact your healthcare coverage.

Shorter Reimbursement Periods: Previously, Medicaid allowed for up to three months of retroactive reimbursement.  This meant that if someone qualified for Medicaid but had not applied yet, the program could cover certain healthcare expenses for three months prior to the submission of the application.

Under the new law, this window has been reduced to just one month.  This change means it is now more important than ever to apply for Medicaid as soon as possible to avoid missing out on covered costs.

More Frequent Recertification: Before the bill, Medicaid recipients were required to recertify their eligibility once a year.  Now, recertification will be required every six months.  This could mean more paperwork and more frequent communication with state Medicaid offices.  Seniors and caregivers should mark their calendars and stay proactive to ensure there are no interruptions in coverage.

New Work Requirements: One of the more controversial changes in the bill is the introduction of work requirements for some Medicaid recipients.  While most seniors aged 65 and older are not directly affected by these requirement, it is worth noting how these new work requirements will affect Medicaid recipients.  Under the new law, most adults must now work, study or volunteer at least 80 hours per month to retain their coverage.  While advocates of the policy argue that it encourages employment and personal responsibility, critics warn that it may disproportionately harm vulnerable populations.

According to recent Congressional Budget Office (CBO) estimates, up to 7.5 million people could lose Medicaid coverage as a direct result of these new rules.  However, this is not solely about people who are unwilling to work.  In reality many individuals may lose coverage due to administrative hurdles, such as missing paperwork, misunderstood instructions or delays in verifying employment.

What is often overlooked is the burden of compliance.  Meeting the work requirement is not just about having a job.  Rather it is about reporting it accurately, on time and every month.  Even small bureaucratic mistakes can result in people losing their coverage, only to re-enroll after lengthy appeals.  This creates gaps in care that can have real health consequences.

What You Can Do: It is important to stay informed of the upcoming changes.  Check in with your local Medicaid office or website for guidelines and updates that are specific to your state.

With recertification happening twice a year, it is important that you stay organized and keep your medical and financial records in order to help streamline the process. Also, it would be wise to place your recertification dates on your calendar so that you make sure you fill out your recertification package and mail it to Medicaid on time.

Lastly with the shortening of the retroactive period, it is more important that ever to apply for Medicaid sooner rather than later.  Should you need to apply for Medicaid or have any Medicaid related questions, please feel free to reach out to Mavros Panagos Law and schedule a free consultation.  Call us at 516-447-0455.

*This article discusses changes to Medicaid based on the passing of a new Federal Law. Check back next week to read about changes to Medicaid that are specific to New York.