Cigna and Medicaid Redetermination
This year, states will be conducting the Medicaid redetermination process for the first time since March 2020. During this process, individuals on Medicaid will be reassessed by their states and will have to provide evidence that they still qualify for Medicaid.
Some states began the redetermination process in February meaning that the earliest anticipated termination date for Medicaid recipients was in April. Please see this schedule to view the timeline for your state.
While the Medicaid Redetermination process is expected to impact millions of Medicaid members, it is estimated to impact only 3% to 7% of Cigna Healthcare customers. Their mission is to improve the health and vitality of those we serve through every stage of life, so they want to partner with you to help support your customers through this process.
What they're doing to help you and your customers:
Once Cigna Healthcare is notified that a state determined a customer to be no longer eligible for Medicaid, the customer will enter the 'deeming period.' During this period, customers will have six months to requalify (90 days in TN).
There is a dedicated team at Cigna Healthcare that will be reaching out to those affected customers directly.
Here are the steps they will take:
- A notice of "Loss of Special Needs Status" will be sent to the customer within 10 days of the confirmed loss.
- Three call attempts will be made by Cigna Healthcare within the last month of the 'deeming period' to obtain proof of Medicaid or inform the customer of other plan options.
- If a customer is interested in other Medicare plans from Cigna Healthcare, their team will transfer them to the Plan Change team if they are eligible. Remember, your Agent of Record (AOR) status is protected for any plan changes made by Cigna's internal team (i.e., Cigna Healthcare employee). Click here to learn more.
- If a customer is unable to confirm Medicaid eligibility and does not change plans within the allotted timeline, their disenrollment will be processed. Note: A notice of involuntary disenrollment will be sent to the customer within the three days following the deemed continued eligibility period.
- The Cigna Agent Resource Line (CARL) team will reach out to the Agent of Record via email when we have been notified of a customer's loss of Medicaid eligibility.
Log in to Producers' University to view the letters that Cigna Healthcare will send to affected customers.
- First letter: Notice of Loss of Special Needs Status
- Final letter: Notice of Involuntary Disenrollment
Centauri Health Solutions:
Cigna Healthcare partners with Centauri Health Solutions to bring your customers no-cost specialized support for enrollment, retention, and redetermination.
In addition to Cigna Healthcare's outreach to customers, Centauri Health Solutions also proactively outreaches to their customers. They do this four times 45-60 days prior to their renewal date to obtain updates and answer questions via mailed letters and phone calls (if the customer does not respond to the letters).
If your customer needs additional assistance in requalifying for Medicaid, you can help them reach out to Centauri Health Solutions, or provide them the following contact information:
Premium Assist (A division of Centauri Health Solutions)
Monday through Friday, 9 a.m. – 7:30 p.m. EST
Additional resources for you:
If you want to learn more about the redetermination process, feel free to review the non-Cigna Healthcare resources below.
- 'Connecting to Coverage' Resource Page
- Medicaid Redetermination 101 One-Pager
- Medicaid Redetermination Fact Sheet
If you have any questions, call us today at 866-568-9649!