Ensuring health care coverage with the help of community health centers

Some people enrolled in Medicaid may be asked to re-enroll in their coverage in order to avoid losing their health insurance through a process called redetermination. But sometimes, the process can be overwhelming and confusing, especially with millions estimated to lose their coverage — either due to no longer qualifying or worse, because of administrative errors.

This is where federally qualified health centers (FQHCs) can play a crucial role. FQHCs are at the center of providing holistic care for Medicaid enrollees in the United States, and in many cases, are on the front lines of helping members navigate the redetermination process.

As each state handles redetermination differently, including with differing time frames, the ways this information has been communicated to members has also varied. FQHCs can help bridge this gap with resources and staff equipped to help educate those navigating redetermination with key information specific to their state so they can avoid losing coverage or be assisted in finding other insurance options.

This can include navigators at FQHCs helping to update contact information so members are receiving the latest communication or giving Medicaid members access to technology to help. Language barriers can also make re-enrolling more difficult, and FQHCs are equipped to assist with translation.

“FQHCs have longstanding programs that provide Medicaid and Marketplace enrollment assistance to patients and community members. The volume of individuals who need to redetermine their Medicaid coverage is at an all-time high. Community health centers have been preparing to provide the assistance needed and have engaged in education, outreach, and partnership promotional efforts,” said Michael Curry, president and CEO of the Massachusetts League of Community Health Centers – a state where an estimated 300,000 individuals could potentially lose coverage.

The number of people on Medicaid FQHCs serve is vast – roughly 1 in 6 Medicaid beneficiaries, according to one estimate. FQHCs provide much more than primary care — preventive care, dental care, behavioral health care and assistance finding resources for social determinants of health are all things that FQHCs can bring together under one roof.

“These centers are trusted entities in the community and have the staff (bilingual and sometimes even trilingual) that are trained and certified to help individuals and families apply for, enroll in, and utilize health coverage,” Michael added.

Ensuring access to coverage is crucial for many components of the health care system, including FQHCs, who treat individuals and families with Medicaid with compassion and expertise. The ability to help Medicaid recipients navigate the redetermination process is another testament to their crucial role underpinning the health of many communities, both urban and rural.

Get more information about redetermination.

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