Medicaid Archives - Healthedly Insurance Services

Understanding Texas’ Maternal Healthcare: Medicaid Pregnancy Coverage

Texas’ maternal health outcomes are some of the worst in the nation. High rates of mortality and morbidity continue at an all-time high among pregnant women. For many Texas women, Medicaid coverage is the only affordable option for receiving the maternal care they need during pregnancy. However, understanding Medicaid eligibility in Texas for pregnancy can be confusing and complex. Here, we discuss what pregnant women in Texas need to know about Medicaid pregnancy coverage, as well as the impact of Medicaid on maternal health outcomes in the state.

What is Texas’ Maternal Mortality Rate?

Texas’ maternal mortality rate (MMR) is an alarming indicator of the state’s poor maternal health outcomes. According to the Centers for Disease Control and Prevention (CDC), the MMR for Texas was the highest in the nation in 2015, with a rate of 32.3 deaths per 100,000 live births. This rate is more than double the national MMR, which was 14.6 in 2015.

In response to these troubling figures, the state of Texas launched the Texas Maternal Mortality and Morbidity Task Force in 2013. The task force was charged with studying the causes of maternal mortality and making recommendations to improve outcomes.

What is Texas’ Medicaid Pregnancy Coverage?

Medicaid is a government health insurance program for low-income individuals and families, including pregnant women. In Texas, Medicaid is administered through the state Health and Human Services Commission (HHSC).

In order to be eligible for Medicaid in Texas, pregnant women must meet certain income and resource requirements. For example, a pregnant woman must have a household income at or below 133% of the federal poverty level. Additionally, the pregnant woman’s resources, such as bank accounts and investments, must not exceed $2,000.

If a pregnant woman meets the income and resource requirements, she may be eligible for full Medicaid coverage for her pregnancy and post-partum care. This coverage includes physician visits, labor and delivery care, and post-partum care.

How Does Medicaid Impact Maternal Health Outcomes in Texas?

The Texas Maternal Mortality and Morbidity Task Force has found that Medicaid coverage is an important factor in improving maternal health outcomes in Texas. Studies have found that pregnant women who have Medicaid coverage are more likely to seek prenatal care. This can improve pregnancy and childbirth outcomes.

Did you recently lose your Medicaid coverage? Reach out to a Healthedly agent today to learn more about options available to you. Call us at 855-522-2201.

February 20, 2023

The End of the COVID-19 Public Health Emergency: Details on Health Insurance and Access

COVID-19, Medicaid, News

The outbreak of COVID-19 resulted in a public health emergency declared by the U.S. government in March 2020. This declaration allowed the government to implement emergency measures to protect citizens’ health, such as expanding access to health insurance coverage, providing funds for vaccine development, and offering economic aid.

On February 4th, 2021, the U.S. Department of Health and Human Services (HHS) announced the end of the public health emergency. This announcement ushers in a new era of health insurance coverage and access. Here’s what you need to know about the new developments.

Expanded Health Care Coverage and Benefits

The end of the public health emergency has enabled HHS to expand healthcare coverage and benefits for individuals and families. The new measures include:

Expanded coverage for telehealth services: Telehealth services enable individuals to access health care remotely without having to leave their homes. HHS has permitted for expanded coverage of telehealth services for Medicare and Medicaid beneficiaries.

Increased access to non-emergency medical transportation: HHS has also increased access to non-emergency medical transportation (NEMT) to ensure that individuals without access to transportation can get to their medical appointments.

Increased access to health services in rural areas: HHS has expanded access to health services in rural areas by increasing access to telehealth services and providing funds for rural health clinics.

Improved Access to Health Insurance Coverage

The end of the public health emergency has also led to improved access to insurance coverage. HHS has implemented the following measures to increase access to insurance coverage:

Extension of Medicaid coverage: Medicaid coverage has been extended for individuals and families struggling to pay for medical care due to the pandemic.

Increased access to marketplace coverage: HHS has also increased access to health insurance coverage in the marketplace. The new measures include a special enrollment period for those who have lost their job-based coverage due to the pandemic.

Increased access to Medicare coverage: HHS has also increased access to Medicare coverage for individuals over the age of 65.

HHS’s announcement of the end of the public health emergency has ushered in a new era of health insurance coverage and access. With the new measures, individuals and families now have improved access to insurance coverage and health care benefits.

Have you lost your Medicaid coverage? Healthedly has your back!

February 14, 2023

How to Identify Early Signs of a Stroke

General, Health, Health Resources, Medicaid, Self-care

In the U.S. today, strokes cause the majority of health complications. Recognizing the early signs of a stroke could be key in preventing serious injuries or fatalities from occurring. It could mean the difference in life or death, or mitigating severe effects caused by strokes.

Early warning signs of a stroke can be subtle. But equipping yourself with knowledge of these tells is crucial to saving yourself or a loved one.

Keep an eye out for:

Intense migraines
Loss of vision or impaired vision in one or both of the eyes
Numbness in the facial muscles
Numbness or sudden weakness in a leg or arm
Slurring speech or brain fog
Comprehension impairment, difficulty understanding
Increased dizziness or difficulty with walking

Keep the FAST acronym in mind if you suspect the onset of a stroke:

F – Facial muscles drooping or numb

A – Arm weakness or impairment–inability to use an arm or lift it up

S – Slurred speech

T – Time to call 911 and get access to the necessary medical attention

Being able to identify the early signs of a stroke means you can seek medical attention earlier in such a scenario. If you or someone in your family is worried about health insurance coverage and want to learn your options, reach out to a Healthedly agent by calling 855-522-2201.

December 7, 2022

Reasons for Medicaid Cancellation

Medicaid

For some people, Medicaid can be a lifesaver, but for others it’s something that they want to get out of–and quick. For starters, let’s address what exactly Medicaid is.

Medicaid isn’t an insurance program. It’s an assistance program. This means that the government administered this coverage for people who are in need, either because of financial hardship or because of disability. When you’re in those positions, being on Medicaid can be a wonderful step up, but it also has its drawbacks.

Here are some Medicaid termination reasons.

#1. You’re Making Too Much Money

Medicaid is a program that you have to qualify for based on your income as it relates to your family size. You may qualify for Medicaid during periods of unemployment or underemployment. Older people who have no savings and are living on a single social security check may need to rely on Medicaid for their care.

But if you’re looking to make more money–if you get a job that gets you out of that low bracket where you’re qualified–then you’re going to want a different kind of insurance. For many people, that insurance may be a health plan through their new employer, but for others it may be a private insurance plan.

While millions of people enroll in Medicaid, the coverage must end when your income exceeds the limits placed on it by the state.

#2. You Move to a New State

Medicaid is not a federal program, but a state-run program, and every state manages their Medicaid programs differently. While you might qualify for this type of coverage in one state, there’s a chance that when you move to another state you will lose your coverage. Consequently, when moving from one state to another many people choose to look for private health insurance programs, or look to other federal funding plans like Medicare or Medicare Advantage.

#3. You Want More Flexibility with Doctors than Medicaid Offers

Because Medicaid is run by the government, there is a lot of red tape that accompanies coverage. That means that many doctors, medical facilities and even some hospitals will not accept Medicaid. While some of these programs create incentives to get Medicaid patients seen by as many doctors as possible, moving to a different healthcare program will open up doors to you that were previously closed.

#4. States Are Planning For The End of Continuous Enrollment Requirement

Medicaid is designed to be a safety net for people who are down on their luck, and there have been suspensions of renewal paperwork or eligibility redeterminations during the pandemic of Covid-19 for states which are receiving enhanced federal funding. As things are resuming more normally in healthcare, the resumption of these eligibility redeterminations will result in people losing their eligibility status for Medicaid. States will need to determine how to approach this change post-pandemic, and so you may need to prepare for a change in your coverage. For those experiencing canceling of their Medicaid, it’s time to look for other affordable health care solutions.

Whatever Your Reason For Getting Off Medicaid, There Are Options

For more information about getting off of Medicaid and switching to a Medicare program, contact us today.

August 23, 2022

Who Doesn’t Qualify for Medicaid?

Medicaid

A doctor meeting with an elderly male patient in an exam room.

Medicaid is a great resource if you’re eligible for it. Knowing whether or not you qualify for Medicaid can be a long and frustrating process of paperwork, never knowing where you stand. We’re going to try to answer some of the most common questions people have about getting Medicaid.

Do You Have to Be Working to Get Medicaid?

It depends on your state, your age, your level of disability, and several other factors. In most cases, you do not have to be working to qualify for Medicaid. You simply have to meet certain financial requirements. For a long time, there were no work requirements. However, a new policy in 2018 made it possible for states to require work-related activities for a specified number of hours each month.

Moreover, people who are over the age of 65, who are pregnant, or who qualify for Medicaid because of federal disability assistance do not ever have to work to qualify.

Of course, this change in policy has been controversial. Why? It is estimated that 80 percent of enrollees who would normally be required to work are unable to due to illness or injury. These individuals usually are acting as a primary caregiver, or a student.

Can You Get Medicaid Under 65?

Yes, anyone from infants to seniors is eligible for Medicaid. Medicaid is primarily an income and disability-based federal health coverage program. Children and pregnant women are commonly eligible. Children cannot work and the law excludes pregnant mothers from the work requirement.

What Makes You Not Eligible for Medicaid?

Medicaid coverage gets primarily determined by looking at the state you live in. Other factors include the number of people in your home, and the total income your household will make in the current year. How do you know if you qualify for Medicaid? Healthcare.gov has an easy-to-use tool that will help you determine if you are eligible for Medicaid.

If you make too much money for the size of your household, you will be ineligible for Medicaid. This is according to the rules set by your state.

The rules for Medicaid vary by state, and the laws change frequently in the Medicaid program. Some administrations focus on expanding Medicaid and some want to tighten the limits on Medicaid. The Department of Health of your state, or the United States Department of Health, will have the most up-to-date resources. This way, you can determine if you can get covered by Medicaid.

Still looking for the right Health Insurance Plan? Browse our plans and get a quote today!

June 10, 2022

Can You Be Dropped from Medicaid?

Medicaid

Yes, there are cases in which you can be dropped from Medicaid, and it can be abrupt. Medicaid has very strict requirements that relate to income and household size, as well as working hours. Every state is slightly different, but here are some good rules of thumb to follow.

Medicaid Is Evaluated Monthly

Losing Medicaid eligibility can be shocking if it happens to you. It may feel like the rug has been pulled out beneath your feet. What you need to understand is that Medicaid qualifications are reevaluated monthly. Any changes to your income or work situation during that month may affect your eligibility.

One case in which people find themselves on this type of health insurance? They have lost their job and are now on unemployment insurance. Generally, if someone has been unemployed and getting unemployment, and their family is of a certain size, then they will qualify for this type of coverage. However, if that person takes on extra work, even something that just pays a few hundred dollars more, it can kick them out of eligibility.

Note that this doesn’t always apply to everyone in the family. Often, the adults in the family will be dropped from Medicaid. However, the children will still be eligible, or a pregnant mother will still be eligible. It can really vary from situation to situation.

Just don’t be surprised if you have been earning a little more than usual and then, boom! You get a letter in the mail that says you’re no longer eligible for Medicaid.

What is Medicaid Eligibility? When Does Medicaid End?

Eligibility and health coverage are determined state-by-state, with different states having different requirements. All of the states have an equation that they use which calculates the upper limit in household income. They calculate for the number of people in the household, and if you cross that state’s Medicaid threshold, you could be dropped from eligibility.

Some states, per a 2018 amendment to the law, have put into effect working requirements that may require program recipients to work as much as 20 hours per week to remain eligible. Though these requirements vary from state to state, they will never apply to those older than 65. Nor will they apply to pregnant women, people who are legally disabled, and children.

You may be asking “I don’t qualify for Medicaid. Now what?” We can help.

Still looking for the right Health Insurance Plan? Browse our plans here.

May 23, 2022

Important Information About Special Enrollment Periods (SEPs)

ACA, Individual and Family, Medicaid, News, Obamacare, Special Enrollment Period, Supplemental

Special Enrollment Periods (SEPs) are a specific time frame during which individuals and families can enroll in a health insurance plan outside of the standard open enrollment period. SEPs are typically triggered by certain life events, such as getting married, having a baby, or losing employer-sponsored coverage.

It’s important to understand that SEPs have strict eligibility requirements and time frames, and failing to enroll during an SEP can result in a gap in coverage or a tax penalty. Here’s what you need to know about SEPs:

Eligibility Requirements

SEPs are only available to individuals and families who experience a qualifying life event, such as:

Marriage
Divorce
Birth or adoption of a child
Loss of employer-sponsored coverage
Moving to a new area with different health plan options
Gaining citizenship or legal resident status
Leaving incarceration

It’s important to note that SEPs are not available to individuals who simply decide they want to change health plans outside of the open enrollment period. You must have a qualifying life event in order to be eligible for an SEP.

Time Frames

SEPs have strict time frames during which you must enroll in a health plan. The time frame begins on the date of the qualifying life event and typically lasts for 60 days. However, the exact time frame can vary depending on the specific life event and the state in which you live.

For example, if you get married, the SEP begins on the date of your marriage and lasts for 60 days. If you have a baby, the SEP begins on the date of your child’s birth and lasts for 60 days. It’s important to enroll within this time frame, as failing to do so may result in a gap in coverage or a tax penalty.

Coverage

SEPs allow you to enroll in a health insurance plan outside of the standard open enrollment period. This means that if you experience a qualifying life event, you can enroll in a health plan even if the open enrollment period has already ended.

It’s important to note that SEPs do not guarantee coverage. If you enroll in a health plan during an SEP, the plan may still have a waiting period before coverage begins. This means that you may have a gap in coverage between the date of your qualifying life event and the date that your coverage begins.

Plan Options

During an SEP, you have the option to enroll in any plan that is available through the marketplace. This includes both individual and family plans. It’s important to compare different plan options and consider factors such as premiums, deductibles, and out-of-pocket costs before making a decision.

It’s also important to note that SEPs do not guarantee that you will be eligible for subsidies, such as premium tax credits or cost-sharing reductions. If you are eligible for subsidies, you must enroll during the open enrollment period in order to receive them.

Enrolling in a Plan

To enroll in a health plan during an SEP, you must complete an application through the marketplace. The application will ask for information about your qualifying life event, as well as your personal and financial information.

You will also need to provide proof of your qualifying life event, such as a marriage certificate or a birth certificate. It’s important to provide all required documentation in order to ensure that your application is processed smoothly.

If you are approved for coverage, you will receive a notice of eligibility. This notice will include information about your premium, deductible, and out-of-pocket costs. You will then have the opportunity to select a plan and enroll in coverage.

If you have any questions about SEPs or the enrollment process, you can contact the marketplace or a licensed insurance agent for assistance. It’s important to get the help you need to make an informed decision about your health coverage.

In summary, SEPs are a specific time frame during which individuals and families can enroll in a health insurance plan. This period is outside of the standard open enrollment period. SEPs are triggered by certain life events, such as getting married or having a baby. These events have strict eligibility requirements and time frames. It’s important to understand SEPs and to enroll within the designated time frame to avoid gaps in coverage or tax penalties.

If you have any questions about SEPs or the enrollment process, be sure to seek the help of our licensed agents here at Healthedly! Give us a call at 855-522-2201!

March 24, 2022

Medicaid is at an All-Time High, But How Long?

Individual and Family, Medicaid

Currently, Medicaid is at an all-time high in terms of enrollment.

Medicaid is a federally funded health insurance program that provides coverage to low-income individuals and families. It is administered by the states, and each state has its own eligibility requirements and benefits. Medicaid is a crucial safety net for millions of Americans. This provider gives access to healthcare services that otherwise may not be affordable.

According to data from the Centers for Medicare and Medicaid Services (CMS), there are currently more than 73 million people enrolled in Medicaid. This is an increase of nearly 10 million people since the beginning of the COVID-19 pandemic.

There are several factors contributing to the high increase in Medicaid enrollment.

One of the main factors is the economic impact of the COVID-19 pandemic.

Many people have lost their jobs or seen their hours reduced. This has led to a loss of employer-sponsored health insurance. These individuals may be eligible for Medicaid coverage. Many have turned to the program as a way to ensure that they have access to healthcare.

Another factor contributes to the increase in Medicaid enrollment. This factor is expansion of the program under the Affordable Care Act (ACA).

Prior to the ACA, Medicaid was only available to certain low-income individuals and families. For example, it was available to individuals such as pregnant women, children, and disabled adults. The ACA expanded Medicaid to cover all adults with incomes up to 138% of the federal poverty level. As a result, more people became eligible for Medicaid coverage, leading to an increase in enrollment.

Despite the increase in Medicaid enrollment, there are concerns about the future of the program. One concern is the potential for Medicaid funding to be cut. Medicaid is a jointly funded program. The federal government provided a portion of the funding and the states providing the rest. If the federal government reduces its funding, it could lead to cuts in Medicaid benefits or the reduction of services.

There are also concerns about the potential for Medicaid to be transformed into a block grant program.

Under a block grant program, the federal government would provide a fixed amount of funding to each state, rather than funding based on the number of people enrolled in the program. This could lead to states having to make tough decisions about who is eligible for Medicaid coverage and what benefits are available.

Despite these concerns, it is important to remember the vital role that Medicaid plays in providing access to healthcare for millions of Americans.

Medicaid has been a lifeline for many people during the COVID-19 pandemic. It is crucial that the program is protected and maintained.

One way that Medicaid can be protected is through advocacy and activism. If you are concerned about the future of Medicaid, consider contacting your elected officials and expressing your support for the program. You can also get involved in advocacy organizations or groups that are working to protect Medicaid and other safety net programs.

In conclusion, Medicaid is at an all-time high in terms of enrollment, but there are concerns about the future of the program. It is crucial that Medicaid is protected and maintained, as it plays a vital role in providing access to healthcare for millions of Americans. If you are concerned about the future of Medicaid, consider getting involved in advocacy and activism to protect the program.

Wondering about what health coverage that you could be eligible for? Well, look no further than Healthedly. Give us a call at 855-522-2201 so our agents can give you a free quote for health insurance.

March 2, 2022

Healthcare.gov: You Can Do This!

ACA, Health Resources, Individual and Family, Medicaid