Pioneers in 5 Star Service • Ronstadt Insurance • Tucson, AZ • 520-721-4848

Archive for Items Categorized 'Compliance'

600,000 Arizonans Could Lose Medicaid Coverage

What Employers Need to Know

An estimated 600,000 Arizonans are at risk of losing their Medicaid coverage now that the COVID-19 Public Health Emergency (PHE) and Medicaid continuous enrollment will be ending. During the PHE, states generally could not disenroll Medicaid participants.

Starting April 1, 2023, and continuing through July 13, 2024, many people will no longer qualify for Medicaid because of the redetermination (eligibility verification) process. About 40% of those losing Medicaid coverage are projected to be eligible for employer-sponsored plans, according to industry research.

As an employer, here’s what you need to know: 

  • Losing Medicaid coverage is a qualifying event. Employers are generally required to offer a special enrollment period to eligible, affected employees.
  • Individuals who are disenrolled in Medicaid may be eligible to sign up for coverage through the ACA Marketplace or Medicare.
  • Communicating information about redetermination to your employees is critical to help avoid a lapse in coverage. Studies show that uninsured individuals are less likely to seek or receive care, especially preventive care. This may lead to a decline in health, increased absenteeism, decreased productivity, and ultimately higher costs for employers. 
  • Detailed Medicaid FAQs can be found at www.azahcccs.gov/Renewals (bottom of page) 

We at Ronstadt Insurance, LLC are here to help you and your employees find the right plan if they lose Medicaid coverage. In addition to your employer-sponsored plan, click here for ACA Marketplace plans for individuals and families. If you have questions, please contact us at 520-721-4848 for more information. 

Public Health Emergency To End May 11, 2023

From Blue Cross Blue Shield of Arizona

During the COVID-19 federal Public Health Emergency (PHE), Blue Cross® Blue Shield® of Arizona (BCBSAZ) aligned with the Centers for Medicare and Medicaid Services (CMS) expanded health benefit coverage guidelines, such as covering COVID-19 testing and testing-related services at no out-of-pocket cost. 

As the incidence of COVID-19 cases has diminished, CMS announced May 11, 2023, end to the PHE. Effective May 11, 2023, BCBSAZ benefits will return to standard benefit provisions. 

What this means for Blue Cross Blue Shield of Arizona Customers:

COVID-19 testing and testing-related services (including telehealth visits for these services) will return to the standard benefit. Depending on your client’s benefit plan, they may have cost-share responsibilities.

Over-the-counter COVID-19 test costs will no longer be reimbursed.

Standard requirements for pre-service review of COVID-19 testing, treatment, and admissions to post-acute care facilities will be reinstated.

Approved COVID-19 vaccines will be covered as preventive services with no out-of-pocket costs when obtained in-network. Out-of-network (OON) vaccines will incur standard OON charges. 

If you have questions regarding your plan’s standard benefits, please consult your benefit booklet on your online member portal at azblue.com/MyBlue