Muña says Presumptive Medicaid may be extended anew

The Commonwealth Healthcare Corp. is optimistic that presumptive eligibility for Medicaid will get another extension.

It was learned at a press briefing last Friday that presumptive eligibility for the Medicaid program was supposed to expire this April but CHCC chief executive officer Esther Muña said that CHCC is expecting to have that extended up to June 2022.

“The presumptive eligibility for Medicaid is expiring next month. We are expecting a possible extension of the program up to June. However, this [won’t be decided by us] as it is a federal program,” Muña said.

Muna

She explained that because the presumptive Medicaid program was established pursuant to the National Public Health Emergency put in place due to COVID-19, a two-months’ notice should have been given before the public health emergency is lifted, ending the program.

“[The program] is based on the National Public Health Emergency. We are expecting an extension and the reason for that is because we understood that it requires at least two months’ notice before the public health emergency ends. If it [expires] next month, it’s less than two months. So that’s not enough time. They’re supposed to give ample time for us to notify the community that the Public Health Emergency is ending. Once the Public Health Emergency Ends, then Medicaid presumptive eligibility ends,” she said.

However, even if the program ends, there will still be a redetermination period to determine whether those who availed of presumptive Medicaid qualify for regular Medicaid.

“For those individuals that are presumed eligible, the Medicaid Office will determine whether they’re eligible for regular Medicaid. So for those eligible for presumptive Medicaid before, the Medicaid Office will let you know if you have an opportunity to apply for the regular Medicaid,” she explained.

Presumptive eligibility, or PE, is an expedited process of enrolling eligible residents in the CNMI Medicaid program. It allows patients to have their care covered while waiting for their application to be fully processed.

It offers immediate access to health care while applying for regular Medicaid or other health coverage. You can start using PE for Medicaid coverage right away for Medicaid covered services, such as doctor visits, hospital care, and some prescription drugs.

Starting the day you are approved for PE, you are able to go to any health care provider that accepts Medicaid.

Individuals and families are eligible for Medicaid if their attested gross income does not exceed 180% of the Supplemental Security Income federal benefit, which is about $28,800 annually for a family of four.