Medicaid Back on Track

What do I need to do to keep my Medicaid going?

Most HSD programs must be renewed. Usually, it is every 12 months.

I don’t remember renewing my benefits lately. Did something change?

The New Mexico Human Services Department made short term changes to our programs. This was to help clients get through the public health emergency caused by the COVID-19 crisis. If you were approved for Medicaid, it was extended every three months. A renewal was not required. If you did renew, you may have had benefits extended for 12 months if you were still eligible.

Did everyone keep their Medicaid during the public health emergency?

Most New Mexicans kept their Medicaid during the public health emergency. Medicaid cases stayed open unless someone asked to have their case closed. Cases also closed if someone died or moved out of state.

How long will my Medicaid stay open?

Medicaid cases have been kept open even if you did not renew. This was a temporary change. We made the change to make it easier for everyone to keep their Medicaid. The change was only during the public health emergency.

When does the public health emergency end?

We’re not sure when the public health emergency will end. It was declared by the federal government. They extend the emergency to help people keep getting through the COVID-19 crisis. It won’t end suddenly. Everyone will get updates before it ends. HSD will tell you before anything changes for your New Mexico benefits.

So I don’t have to do anything to keep my HSD benefits?

When the public health emergency ends, HSD’s benefits will get Back on Track. This means we will go back to our normal way of doing things. Most HSD programs must be renewed. This includes Medicaid. It includes SNAP, CASH and Energy assistance programs. HSD will try and renew your Medicaid automatically. If we can’t renew you, you will get a letter. The letter will say it is time to renew. You can return the letter. Or you can renew online at www.yes.state.nm.us.

What do you mean by getting Back on Track?

HSD made changes to some things. This included the way people could apply for or renew benefits. These changes were temporary. The changes had to be approved by the federal government. When the public health emergency ends, the temporary changes will end. We will get Back on Track with HSD normal processes. Getting Back on Track will make sure anyone who is eligible for HSD benefits can keep getting them.

What happens if I don’t renew my Medicaid?

If you don’t complete your renewal in time, your Medicaid could close. Make sure all information HSD has is up to date. Tell HSD/ISD about changes that could affect your eligibility. That means changes in address, income, family size, or other factors.

What is a Medicaid category of eligibility (COE)?

When you are approved for Medicaid, you are approved for a specific category of eligibility (COE). The COE someone is approved for can depend on many factors. These may include age, income level or health status. The COE you are approved for determines the services you get from Medicaid.

Can the Category of Eligibility (COE) I am approved for change?

The category of Medicaid you are approved for may change. It may be different if you have a change in age, household income, living situation, health, or pregnancy status. Your Medicaid benefits are based on the COE that you get.

Will my Medicaid benefits change when the public health emergency ends?

Your benefits could change. When the public health emergency ends, we will see if you are still eligible. You must meet guidelines to get Medicaid. You must return information if we ask for it. You have to do this when we ask for it. If you don’t give us information when we need it, your Medicaid could close. If you need help getting things we need, ask us to help you. Or ask for more time.

What will HSD use to see if I am still eligible for Medicaid?

Those who apply or recertify for HSD programs must meet a set of terms to be eligible. These include citizenship, residency, household size, income, and other factors. HSD will use electronic sources to check information. This is to run or renew applications.

Why does HSD send me so many things? I always get mail from you.

HSD needs to let you know what is happening with your case. We want you to keep the benefits you get. Sometimes, we need more information. If we do, we will ask for it. You can usually give us what we need online at www.yes.state.nm.us. You can also call us at 1-800-283-4465.

I think everything you send me is junk. I don’t even look at it.

We only send you things when we need information that will help you get or keep benefits. Or if we need to give you information about your benefits. When the public health emergency ends, you will need to recertify your Medicaid. That may be the only way we can keep your Medicaid going. Please reply to the letters we send you so we can keep your benefits up to date.

Will my Managed Care Organization (MCO) change when the public health emergency ends?

If you are still eligible for Medicaid, you will stay enrolled with your MCO. Your MCO should not change unless you ask to switch to a new MCO. You can only switch MCOs at certain times. Or for certain reasons. You can get more information at www.yes.state.nm.us. You can also call us at 1-800-283-4465.

I am a Native American and I don’t have an MCO. Can I keep getting my Medicaid through Fee for Service when the public health emergency ends?

If you have Medicaid through Fee for Service now, you can keep getting services the same way when the public health emergency ends. That is if you are still eligible. And if you have the same category of eligibility. Native Americans who have both Medicare and Medicaid must be enrolled with an MCO. Native Americans that require a nursing facility level of care must also have an MCO.

Why did I lose Medicaid?

Your Medicaid could close for different reasons. You could lose it if you are no longer eligible. You might not be eligible because things have changed. These could be changes in income, household size or living situation. Eligibility could also change because of a change of health or pregnancy status. You could lose Medicaid if you don’t renew your benefits. Or if you don’t respond to information HSD has asked you for in time.

What if my income is too high to get Medicaid? Is there someplace I can get affordable health insurance?

If you aren’t eligible for Medicaid because your income is too high, you may be able to get insurance from beWellNM. Through beWellNM, you can shop for insurance. You may also be able to get help paying for insurance. beWellNM can also help if you have insurance with limited benefits. This includes Medicaid Family Planning. You can get more information at www.bewellnm.com. Or you can call 1-833-862-3935.