Medicaid Eligibility Annual Reviews Resuming Next Week New Document Upload Tool Available for Healthy Connections Medicaid Members
COLUMBIA, S.C. – The South Carolina Department of Health and Human Services (SCDHHS) will resume its standard Medicaid eligibility annual reviews process April 1, 2023. This federally required process is in place to ensure those enrolled in Medicaid programs continue to meet established eligibility criteria. During the COVID-19 federal public health emergency (PHE), states were required to pause annual reviews and keep Medicaid members enrolled with very limited exceptions. The Consolidated Appropriations Act, 2023, passed by Congress and signed into law by President Joe Biden Dec. 23, 2022, directed states to resume annual reviews.
SCDHHS will first attempt to renew individuals’ Medicaid eligibility with information that is already available. If SCDHHS can verify continued eligibility this way, a Medicaid member will receive a “continuation of benefits” notice and will not receive an annual review form.
If continued eligibility cannot be confirmed with information already available, the agency will notify the Medicaid member and mail a form to be completed and returned. Annual review forms must be filled out completely and returned within 60 days. The return date will be included in the information the agency sends to impacted Medicaid members.
For members who have provided SCDHHS with a cell phone number, the agency will also send a series of text messages to remind the member to return their review form if they have not done so already. The member may opt out of this service by following the instructions in the initial text message.
New Document Upload Tool
Members may now return their form through the agency’s new document upload tool . The tool is an online resource for members to provide requested information, report a change in income, return an annual review form or submit other documents. The information received through the tool will allow SCDHHS to contact members if there are any questions about the documents. The document upload tool and instructions for how to use it are located at apply.scdhhs.gov . Members may also continue to return their annual review form and other documents through the options included below:
- Mail – SCDHHS Central Mail, PO Box 100101, Columbia, SC 29202;
- In-person – Visit www.scdhhs.gov/site-page/where-go-help for a list of local eligibility offices;
- Email – email@example.com ; or,
- Fax – (888) 820-1204
Information for Healthy Connections Medicaid Members
While members will begin receiving notices and review forms in April 2023, the agency anticipates it will take 12 months to complete this process. This means some members will not receive their notice or annual review form until March 2024.
It is very important SCDHHS has updated contact information for its Healthy Connections Medicaid members. If members have moved without informing SCDHHS, they may miss important information and forms needed to keep their Medicaid eligibility. Members can update or add their contact information by:
- Visiting apply.scdhhs.gov ;
- Calling (888) 549-0820 Monday through Friday from 8 a.m. to 6 p.m.; or,
- Visiting an SCDHHS local eligibility office (a list is available at www.scdhhs.gov/site-page/where-go-help ) .
If a member receives an annual review form instead of a continuation of benefits notice, it does not mean they are no longer eligible. It does mean they need to fill out the review form completely and/or send SCDHHS other information needed to determine if they are still eligible.
SCDHHS has produced a fact sheet for Healthy Connections Medicaid members that is available on its annual reviews website at www.scdhhs.gov/annualreviews . Members with questions should contact the Healthy Connections Member Contact Center at (888) 549-0820. Community organizations, such as SC Thrive (800) 726-8774, are also able to answer questions.
Federal law requires all state Medicaid agencies to check the eligibility status of Medicaid members annually to ensure those who are enrolled remain eligible for the program. Provisions of the Families First Coronavirus Response Act (FFCRA) required states to maintain continuous eligibility for Medicaid members who were enrolled as of March 2020 throughout the COVID-19 federal PHE. To comply with the FFCRA, SCDHHS paused its standard annual review process and only removed members from the Healthy Connections Medicaid program if they moved, requested to be removed or passed away.
The Consolidated Appropriations Act, 2023 , passed by Congress and signed into law by President Joe Biden Dec. 23, 2022, requires state Medicaid agencies to resume their standard annual eligibility review processes April 1, 2023.
About the South Carolina Department of Health and Human Services
The South Carolina Department of Health and Human Services provides health care benefits to nearly 1.3 million South Carolinians. The agency’s mission is to be boldly innovative in improving the health and quality of life for South Carolinians.