The United States Department of Health and Human Services (HHS) declared a public health emergency (PHE) in early 2020 in response to the COVID-19 outbreak. Normally, the state Medicaid agency is required to complete a Medicaid redetermination process once a year to review Medicaid eligibility for current members. During the PHE, this process was put on hold.

States are now required to resume regular eligibility redeterminations for Medicaid enrollees no later than April 1, 2023, per the Consolidated Appropriations Act of 2023 (CAA). Individuals who no longer meet Medicaid eligibility requirements or fail to supply information needed to complete an eligibility redetermination will lose Medicaid coverage during the redetermination process and will have to seek another form of health care coverage.

Accordingly, the Rhode Island Department of Human Services (DHS) will be resuming eligibility redeterminations for Medicaid members on April 1, 2023. Not all members will receive their redetermination at the same time; the state has 14 months - or until May 31, 2024 - to complete all Medicaid redeterminations.

How can providers help?

As a part of our members’ care team, we would appreciate your help in spreading the word about the following key messages and Blue Cross & Blue Shield of Rhode Island (BCBSRI) resources to help members navigate the resumption of Medicaid redeterminations. Please remind members of the following:

• Update their contact information – Make sure DHS has the member’s current mailing address, phone number, email, or other contact information. This way, they’ll be able to contact the member about their Medicaid coverage.
  • Online: Members can visit www.healthyrhode.ri.gov
  • Phone: Members can call HealthSource RI at 1-855-840-4774 or R.I. DHS at 1-855-697-4347
• Sign up for text messages – Medicaid members can also sign up for text messages so they can receive notifications faster by logging in to their account at www.healthyrhode.ri.gov, clicking “My Profile,” and checking the “Sign up for Text Messages” box under the “My Contact Information” section. Instructions will walk the member through how to complete the process and validate the cell phone for text messaging.
• Check their mail –  DHS will mail the members a letter about their Medicaid coverage. This letter will also let the member know if they need to complete a renewal packet to determine if they still qualify for Medicaid.
• Complete their renewal form (if they get one) – Fill out the form and return it to DHS immediately to help avoid a gap in their Medicaid coverage. We have a team of BCBSRI Medicaid Specialists to help BlueRI for Duals members through the Medicaid redetermination process. If an individual could use some help, have them reach out to us at 401-459-1405, we are open Monday-Friday 8:00 AM to 4:30 PM. We’ll be happy to help!