Some South Carolina residents have recently received several letters explaining that they were denied Medicaid coverage before finding out in other letters that they are actually enrolled in the program.
Medicaid Deputy Director Beth Hutto said the agency is required to screen applicants for a variety of Medicaid categories. While some applicants may be denied coverage under one category, they could qualify for another, she explained.
The agency must send denial letters for each category that an applicant is determined ineligible.
"It's going to be confusing for the consumer because there will be some consumers who get a couple of denials and then end up with a Medicaid card," Hutto said.
Staff members at the Palmetto Project, a local nonprofit that provides free assistance for residents filing Medicaid applications, are available for help in person or by phone, 1-888-998-4646.
For more information, visit palmettoproject.org/just-receive-lot-mail-sc-dhhs/.
The state Medicaid agency finished processing a substantial backlog of low-income health insurance applications ahead of its self-imposed deadline last month.
Apply for South Carolina Medicaid
By phone: 1-888-549-0820
In person: 326 Calhoun St., Charleston.
The agency promised the federal government it would process approximately 40,000 applications - some of which had been filed nearly a year ago - before Aug. 21. In mid-July, it had only managed to make its way through about 25 percent of them.
Normally, Medicaid applications are processed within six days.
The department implemented new productivity standards and assigned more employees to the task to clear the backlog.
"I'm proud of our team," Medicaid Director Tony Keck said Wednesday. "I think we got a good result in the end."
All of the backlogged applications were filed through the Affordable Care Act's new health insurance marketplace. An unexpected transfer glitch between the federal government and the state agency kept thousands of residents waiting for many months before they learned whether they qualified for the low-income health insurance program.
This problem wasn't unique to South Carolina. The federal Centers for Medicare & Medicaid Services sent letters to several states in late June, warning them that they needed a plan in place to process these applications more quickly. South Carolina did not receive one of those letters, but the Medicaid agency participated in regular conference calls to update federal officials on the state's progress.
Beth Hutto, Medicaid's deputy director for eligibility, said the department determined about 60 percent of the applications transferred from the federal insurance marketplace were eligible for Medicaid.
That percentage would have been higher if South Carolina chose to expand eligibility for the program, as prescribed by the Affordable Care Act. In 2012, the Supreme Court decided Medicaid expansion was an optional provision of the federal health care law and states can opt out if they want to. South Carolina will not participate in the expansion, meaning that most adults without children in this state will not qualify for the program, no matter how low their income is.
Residents can apply for Medicaid at any time during the year, but Hutto said she expects another application uptick once enrollment for private health insurance plans re-opens on the federal marketplace in mid-November. Transferring the Medicaid applications from the federal government to the state agency won't be such a problem anymore, she said.
"We should be getting those applications in real time, so we shouldn't be getting a big dump at one time," Hutto said. "It will be more manageable."
About 1.1 million South Carolinians are already enrolled in Medicaid. More than half of them are children.
Reach Lauren Sausser at 937-5598.
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