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Enrolling Virginians in Medicaid with Deepak Madala

(Nov. 12, 2018) Catherine Read sits down with Deepak Madala, Director of Enroll Virginia, to discuss the process of enrolling Virginians in Medicaid. Enroll Virginia was created by the Virginia Poverty Law Center, and is a non-partisan community based effort to educate all Virginians about the new health insurance marketplace and provide free, unbiased assistance with the application and enrollment process.

When the Virginia General Assembly passed Medicaid expansion this year, Virginia became the 33rd state to expand Medicaid through the Affordable Care Act (ACA). Approximately 400,000 Virginians became eligible for benefits. Deepak explains how Enroll Virginia is working hard to reach eligible participants, and get them signed up for health insurance. Madala notes that Virginia has the benefit of learning best practices, and pitfalls, from the states that have already gone through this process.

Medicaid is sometimes confused with Medicare. Both Medicaid and Medicare are public health insurance programs but Medicare is administered solely by the federal government and provides coverage for seniors aged 65+, people with disabilities, and those with end stage renal disease. Medicaid (the subject of this show) is a partnership between the federal government and the state governments, designed to provide health insurance coverage for those in poverty. When the ACA passed in 2010, it afforded the states the option of expanding Medicaid with federal dollars for adults aged 19-64 who are considered the “working poor”. Applicants can make up to 400% of the poverty level and still qualify for this program. The state administers and sets guidelines for this program, however it is funded through federal tax dollars.

Deepak Madala VPLCEnroll Virginia is working hard to reach everyone who is eligible for this coverage. They are leveraging partners in the social services arena to spread the word and educate the public.   “Train the Trainer” workshops are being scheduled throughout the commonwealth. This is helping to educate social workers and case managers, so they can better understand and communicate eligibility and benefits. Organizations can contact the Virginia Health Care Foundation to register for a SignUpNow workshop. There are no restrictions of who can receive this training; it can be a non-profit, a religious organization or even a business.   The rules have changed for the better here in Virginia, and their mission to ensure that the word gets out.

For those who are interested in finding out if they are eligible, they can simply call the 1-800 number to speak with a trained representative, go online to do the application or they can mail in a paper copy. The applicants will need to provide information about income, and after that is verified they will know what benefits they are eligible for. If the applicant calls in, and their income can be verified on the spot, then they may not even have a waiting period to know how to proceed.

Enrollment for Medicaid is rolling, so there is no deadline to get signed up (as there is in traditional insurance plans). However, the deadline for securing insurance with the ACA State Marketplace is December 15th. So, if an applicant is not sure of whether or not they are eligible for Medicaid Expansion they should contact the office as soon as possible, because if they do not qualify for Medicaid then they have adequate time to secure private insurance by the December 15th deadline.

There are six different plan options available to all Virginians, which are different health insurance networks. Coverage is not limited, and there are no premiums, co-pays or deductibles. There is also a specific emphasis on preventative care, things like immunizations and well visits. When choosing a plan, applicants will want to review the various networks to find their current doctors, in order to ensure that they are finding a plan that best meets their needs. Many of the free clinics, where these patients currently seek care, will have counselors on hand to help patients navigate getting signed up for Medicaid and best understand all of the different options.

For people who are already receiving certain benefits from the state, such as FAMIS, Virginia’s health insurance program for children, or Supplemental Nutrition Assistance Program (SNAP) benefits, the state has technology in place to assess eligibility for other family members. Recipients should expect to receive a YELLOW envelope in the mail, where they will need to complete a few more pieces of information in order to finalize the application. The goal of the program is to enroll as many eligible participants as possible. If people do not receive this envelope, they should visit the CoverVA website, call 1-855-242-8282, email [email protected]or fill out a paper application at their local social services office to determine eligibility.

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