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How Medicaid Redetermination Might Impact Your Medicare Coverage

Find out how Medicare Redetermination might impact your Medicare coverage if you lose your Medicaid coverage. Contact us for assistance.

2 mins read
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In this Medicare 101 video, we the potential impact of Medicaid Redetermination on your Medicare Coverage In this video, you will learn:

✳️ What is Medicaid?

✳️ How does Medicaid work with Medicare?

✳️ What is Medicaid Redetermination?

✳️ News about Redeterminations

✳️ and more!

What is Medicaid?

Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. Medicaid offers benefits not normally covered by Medicare, like nursing home care and personal care services. *The rules around who’s eligible for Medicaid are different in each state.*

Generally, you must meet your state’s rules for your income and resources, and other rules (like being a resident of the state).

You might be able to get Medicaid if you meet your state’s resource limit, but your income is too high to qualify.

How does Medicaid work with Medicare?

Medicaid and Medicare often work together to provide healthcare coverage for individuals who are eligible for both programs, also known as “dual eligible” beneficiaries. Medicaid can help cover costs that Medicare does not, such as long-term care services. Additionally, Medicaid can help pay for Medicare premiums, deductibles, and copayments, reducing healthcare costs for dual-eligible beneficiaries. However, Medicaid redetermination can impact the relationship between these two programs.

What is Medicaid Redetermination?

Medicaid redetermination is the process of reviewing a recipient’s eligibility for Medicaid to ensure that they still meet the program’s criteria. Medicare, on the other hand, is a federal health insurance program that primarily serves individuals aged 65 and older, as well as certain individuals with disabilities. In this paper, we will discuss how Medicaid redetermination impacts Medicare.

News about Redeterminations Starting in 2023

States will have the ability to resume the Medicaid Redetermination process after three years of being paused due to the COVID pandemic.

States can begin to initiate the redetermination process as early as February 1, 2023, and disenrollments can be effective as early as April 1 if adequate notice is given to the enrollee. Each state will set the date for when redetermination will start.

Approximately 15 million individuals will be at risk of losing Medicaid coverage. Anyone who is no longer eligible for Medicaid will be disenrolled. Members set to be disenrolled from their Medicaid plans will need to obtain new coverage and maintain continuity of coverage.

What does this mean for dual-eligible beneficiaries?

Individuals who are currently in Dual Special Needs Plans (‘D-SNP’) Medicare Advantage plans (specially designed for dual-eligible beneficiaries) that receive notice telling them they are no longer eligible should contact their broker to discuss regular Medicare Advantage plan options.

You will have a 60-day window during which you can transition to a regular Medicare Advantage plan or return to Original Medicare.

All other dual-eligible individuals who are in Original Medicare or a regular Medicare Advantage plan will be able to stay in their current plan.

If you need help finding a regular Medicare Advantage plan, reach out to CoverRight.


CoverRight is on a mission to make the Medicare plan selection process easy to understand. We are here to help you find the best Medicare plans suited to your specific situation.

🎂 If you’re turning sixty-five or retiring then you know you have to make a Medicare decision. We help you understand the Medicare system and help you make the best decision based on your needs. We take the confusion out of the process and never push specific insurance products. We believe Medicare is NOT one size fits all.

🎙️ In this channel we cover the following Medicare topics

✳️ Medicare Advantage

✳️ Medicare Supplement Plans

✳️ How to evaluate the difference between Medicare Supplement Plan G vs Plan N

✳️ Medicare Advantage vs Medicare Supplement

✳️ When You Can Enroll in Medicare and the different enrollment windows

✳️ How to evaluate Medicare plans and costs and more. If you have Medicare questions or want to speak with someone about your specific situation contact us.

Josef Katz

Josef is a digital marketing expert, is a podcast host of PrimeLife and formerly a licensed insurance agent. Josef has had an extensive career across the education, healthcare, insurance and financial services sectors and is passionate about educating consumers.

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