LA HAP Bulletin for 3/26/19

Information for Medicaid enrollees and dual eligible LA HAP clients

During a time of transition for Medicaid and based on your feedback, LA HAP would like to issue some reminders to our community.

• Medicaid is moving from annual to quarterly eligibility checks for all enrollees on a rolling basis. To begin this transition, approximately 37,000 Medicaid recipients will lose coverage after March 31st as their incomes have been determined to exceed program limits. Individuals in this situation with HIV are encouraged to apply to LA HAP.
  • Individuals should save their letter from Medicaid stating the date they lost benefits. If they apply to LA HAP and their income still appears to be within Medicaid limits per our staff’s calculations, attaching a copy of the Medicaid letter to their application will ensure that they can receive their full 6 months of eligibility without having to re-apply for Medicaid.
  • Any individual who loses coverage is most likely eligible for a Special Enrollment Period for the Marketplace. SEPs last for 60 days past the date of lost coverage. Therefore, this period lasts until May 30th for those losing coverage on March 31st.

• Dual-eligible enrollees often face special challenges understanding and navigating their benefits. This is partly due to the fact that their benefits are determined, administered and paid for by numerous entities including Louisiana Medicaid, their managed care organization, Medicare, their Part D insurer, the SSA, LA HAP, and HIP.
  • LA HAP is currently working with Medicaid to better understand and interpret eligibility decisions.
  • If you have a client who is denied LA HAP benefits based on their full dual eligibility status but who is still experiencing medical bills apart from standard drug copays between $1.25 and $8.50, please call Erin or Alicia to discuss. Save any and all documentation related to this client’s situation so LA HAP staff have grounds to potentially approve the client for limited LA HAP services.