The letter sent to CMS in June 2013 also asked about estate recovery disclosure in cases where coverage is auto-renewed during the annual redetermination process, when people are shifted from a subsidized plan to Medicaid due to a decrease in income or other change in circumstance, and when people are auto-enrolled on the presumption that they are eligible according to a database such as SNAP (food stamps) or by a hospital or health care center. A similar letter was sent to the Massachusetts Office of Medicaid.
The federal procedural rules on estate recovery say the state should notify Medicaid recipients about the estate recovery program during the annual redetermination process, but according to the Massachusetts Office of Medicaid, you don't need to be informed about estate recovery during the redetermination process because you presumably read about this on the original application you filled out and submitted.
If you submitted an application that did not disclose estate recovery, it cannot be presumed that you are aware of estate recovery, because notification was not on the application. Thus, the redetermination procedure is one more example of the failure to disclose.
If you are bumped into Medicaid from a subsidized plan due to a change in your circumstances, the Massachusetts Office of Medicaid believes that you don't need to be informed about estate recovery because you presumably read about this however many years ago when you filled out the original application. You will simply be sent a notice that you are now in Medicaid, and the notice will refer you to the Medicaid Member Booklet for information on the rules. If you obtain and read the booklet, you can learn that you may be subject to estate recovery. But don't expect to receive a Medicaid Member Booklet with your notice, because "It would be cost prohibitive to include a Member Booklet with every notice. Instead, every notice includes information on how to contact Customer Service with any questions, including to request a copy of the Member Booklet."
Hope you know what questions to ask and that you do request a copy of the booklet immediately, pray that it arrives before you use any Medicaid services if you are age 55 to 64 and go over it with a fine tooth comb. If you don't want to be in Medicaid, you can contact your state Medicaid agency to unenroll, but you'll probably have to pay a penalty for being uninsured unless you can earn more money and get into a subsidized plan.
If you submitted an application that does not disclose estate recovery and you are bumped into Medicaid due to a change in your circumstances, you won't know about this detrimental practice, but you can learn that your assets may be confiscated if you contact Customer Service and request a Member Booklet.
If you are auto-enrolled into Medicaid because you were presumed eligible through a SNAP (food stamp) database or by a hospital or health care center, you may still need to fill out a full application which may or may not disclose estate recovery.
Now let's look at how the federal exchange at healthcare.gov will handle these situations.
The federal exchange will not be renewing coverage for Medicaid recipients. Your state Medicaid agency will handle your annual Medicaid eligibility redetermination (renewal). CMS responded to the citizen's inquiry as follows: "State Medicaid agencies are developing their own renewal forms which may include a notice regarding estate recovery. CMS is in the process of finalizing a model renewal form to assist states, and we appreciate that you highlighted this requirement."
Why did CMS need to be reminded about notification of estate recovery when the federal procedural rules that CMS is supposed to implement specify that notification is required?
You may receive a renewal form if your state Medicaid agency doesn't employ the same "streamlined Obamacare procedures" that Massachusetts is using or if you did not choose auto-renewal. Your state Medicaid agency might come up with its own procedure for redetermination regardless of which option you checked on your original application. In any case, the renewal form might not include disclosure of estate recovery although your state Medicaid agency is familiar with the estate recovery notification requirement outlined in the federal procedural rules.
According to CMS, if you are bumped into Medicaid due to a change in your circumstances, your state Medicaid agency may notify you that you are now in Medicaid and "may include Medicaid-specific information as appropriate."
If the state Medicaid agency sends a notice that you have been bumped into Medicaid, you might also receive Medicaid-specific information -- or you might not. The notice will refer you to a pamphlet and provide you with a website address so you can learn that your heirs can be dispossessed in exchange for your being provided with minimal medical care.
If you are auto-enrolled because you were presumed eligible through a SNAP (food stamp) database or by a hospital or health care center, your state Medicaid agency will most likely send you a full application which might or might not disclose estate recovery.
Oregon fast-tracked residents into Medicaid in October 2013 by sending approximately 240,000 letters to those on food stamps. The Oregon Health Authority already had people's information on file since they were participants in an income-based state program, and, thus, presumed eligible for Medicaid. The letter explained that all they had to do was let the Oregon Health Authority know they wanted to be enrolled in Medicaid by checking the "I-am-interested" box, provide some basic information on the enclosed one-page form and return it to the Authority in the enclosed stamped and addressed envelope. The Oregon Health Authority then worked on enrolling the 75,000 respondents and proceeded to send 177,000 reminder notices.
Did the one-page form contain notification of all rights and responsibilities including estate recovery?
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