Ensuring Ongoing Medicaid Enrollment

Section Highlights:

Value of Ongoing Enrollment

It is crucial that hospitals not only connect patients and their families to temporary Medicaid coverage, but also help them fill out the full application for coverage. This ensures that eligible patients will maintain continuous coverage, even after the temporary eligibility period ends. Patients consider their health care providers to be trusted messengers about their care and about their coverage needs, so providers are well-positioned to connect patients with other community partners who can help them obtain — and retain — health coverage. Leveraging this relationship and connecting patients to coverage is in the interest of both the patient and the provider, and it helps ensure that care is available to those who need it.

Taking up the new presumptive eligibility option can also help build the hospital’s relationships with patients and with the community.

  • Patients
    Establishing relationships with patients and their families and helping them enroll in Medicaid strengthens the connection between your hospital and the patients you serve. These relationships make financial sense for your hospital, and they position your hospital to be a trusted source of information for patients about their health coverage and care.
  • Community
    There are likely people and organizations in your community that assist individuals with the application and enrollment process for health coverage (for Medicaid, other public assistance programs like the Children’s Health Insurance Program, and the new health insurance marketplaces). Developing relationships with and referring patients to these organizations to complete their full application for coverage — if staff in your hospital are not already helping patients complete the application — is also in the best interest of your hospital, your community, and your patients.

Tip → Hospital staff and volunteers should consider becoming Certified Application Counselors (CACs). The training and certification process varies by state, but this is an opportunity for hospitals to host trained staff who can directly assist patients with the new application and enrollment process. To learn more about this opportunity, see our CAC Organization Toolkit.

Identifying Local Enrollment Assistance

Enrollment assisters go by many different names and have different sources of funding and areas of expertise. Identifying who can help your patients complete the full Medicaid application will be a crucial component of ensuring your hospital maintains the ability to make presumptive eligibility determinations in the future. Enroll America’s locator tool can be used to provide your hospital with a list of local organizing that are providing application assistance. This list includes navigators and in person assisters, community health centers, and a number of agents and brokers.  Your hospital should also connect with the following types of enrollment assisters:

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