Fallout from the Great Unwinding - Western Asset Protection
Great Unwinding creates opportunities for Medicare agents

Fallout from the Great Unwinding

When the COVID-19 Public Health Emergency came to an end on May 11, 2023, so did Medicaid’s continuous coverage requirement, which directed states to keep Medicaid recipients enrolled regardless of their eligibility. States have begun disenrolling members who no longer qualify. This period of undoing COVID health coverage requirements and returning to pre-pandemic norms is known as the Great Unwinding. It is anticipated that as many as 17 million people will lose coverage. Some of those impacted will be dual eligible (D-SNP) enrollees with Medicare Advantage plans. This Medicaid Enrollment and Unwinding Tracker shows the latest data and covers disenrollment start dates by state.

What This Means in Arizona

As of April 1, 2023, more than 2.4 million Arizonans were covered by Medicaid – 6.5% of the population is over the age of 65. Arizona’s Medicaid agency, the Arizona Health Care Cost Containment System (AHCCCS), began checking eligibility status on April 1 and plans to complete the process by the end of the year. The AHCCCS is trying to determine eligibility and automatically renew as many members as possible with no disruption. The AHCCCS said it was able to process roughly three-quarters of renewals automatically, without needing the enrollee to provide any additional information. Despite these efforts, nearly 150,000 people have lost coverage since April – and that number will increase over the coming months.

It is clear many of these Medicaid members are still unaware of the unwinding and don’t know what action to take when they do become aware. They are at risk of becoming uninsured.

Outreach and Education Is Needed

This confusion creates opportunities for Medicare agents to step in and assist seniors by educating them on what is happening and provide guidance.

Those who lost eligibility because they did not respond in a timely manner to requests for more information can regain their eligibility. They need to contact the AHCCCS at 1-855-432-7587 at any time between 7 am and 6 pm, Monday through Friday. Those who have an account can log into www.healthearizonaplus.gov. All enrollees should make sure their contact information is up to date.

Insurers will notify seniors with dual-eligible Medicare Advantage plans who no longer qualify for Medicaid. They will have a Special Enrollment Period, which they can use to enroll in a new Medicare Advantage plan or switch to Original Medicare with a Prescription Drug Plan.

You have probably already reached out to your D-SNP clients to educate them on what is happening and to help them find new plans if they are no longer Medicaid eligible. How do you find others who have been impacted? This is where your efforts to cultivate relationships and network within your community becomes important. Reach out to your contacts in groups and organizations to make them aware that you are available to help. Offer to leave your flyers and business cards. Some places to network include:

  • Doctors’ offices, provider groups, health care clinics, pharmacies – Many people find out they’ve lost their Medicaid eligibility and are no longer insured when they are seeking care.
  • Chamber of Commerce, realtors, small business associations, school boards.
  • Senior groups, community centers, churches, libraries, home shows, farmers markets.
  • Groups that provide free assistance to seniors – Food banks, pro bono law work, volunteer income tax assistance.
  • Social media – Use your social media profiles to tell your current clients that you will take referrals if they know other seniors who have lost their Medicaid eligibility.
  • Local media – Present yourself as an expert source by educating the public about upcoming changes.

Whether you are helping your current clients or reaching out to your community to educate potential new clients, you are building awareness for your business. Plus, you are helping people avoid the potentially catastrophic consequences of being uninsured.

Unwinding Fraud Alert

Insurance fraud is already prevalent, but this unwinding period has created new opportunities for scammers. Medicaid enrollees have reported that they are receiving calls telling them they are at risk of losing their health insurance unless they pay a fee. Alert your current and potential clients to this scheme to help them protect themselves against fraud.

The team at Western Asset Protection is dedicated to helping you grow your business and reach your goals. Contact us today.