Seniors receiving long-term care and people with disabilities extended for 12 months
SANTA FE – Today, the New Mexico Human Services Department (HSD) announced a significant extension of Medicaid coverage for seniors receiving long-term care and individuals with disabilities. This move, approved at the federal level, means that those enrolled in various Medicaid waiver programs will have their coverage extended for an additional 12 months.
“We are committed to reducing barriers to health care services for our most vulnerable Medicaid members,” said Kari Armijo, cabinet secretary for the New Mexico Human Services Department. “By securing this federal flexibility, we aim to ensure that every eligible individual receives the health care they need.”
This federal flexibility applies to Medicaid waiver programs, including the Community Benefit, Developmental Disabilities Waiver, Mi Via Waiver, Supports Waiver, and the Medically Fragile Waiver. This extension also applies to Medicaid members living in intermediate care facilities and nursing homes.
Eligible Medicaid members include individuals whose Medicaid renewals were due after April 1, 2023, and have not yet been processed by HSD. They must currently have a Level of Care on file with the Medicaid program, which outlines their need for full-time care and supervision, including medical and non-medical assistance typically provided in long-term care facilities.
Medicaid coverage for these members will automatically be extended for 12 months from their last renewal due date. HSD will notify them by mail about the extension of their coverage. This coverage extension does not include Medicaid members whose coverage ended because they did not return renewal packets or those who failed to provide required documentation.
Additionally, because this federal flexibility is related to the rollback of temporary pandemic-era policies, it will not apply to Medicaid coverage renewals scheduled from May 2024 onwards.
FAQs**
What is an Active Level of Care (LOC)?
An “Active Level of Care” (LOC) refers to a current and valid assessment of a patient’s healthcare needs. It is a clinical tool used to determine the type and intensity of medical or personal care required by an individual, and is critical in qualifying for certain Medicaid benefits, such as long-term care services. The active LOC is necessary to ensure the beneficiary continues to meet the medical requirements of the Medicaid program.
How will I know if my eligibility has been extended?
Medicaid customers affected by this change will receive a notice by mail stating that their eligibility has been extended, with no need for further action on their part.
What should I do if I haven’t received a notification?
If you believe you are eligible for this extension but have not received a notification by mail, please contact the New Mexico Human Services Department at 1-800-283-4465 for assistance.
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The Human Services Department provides services and benefits to 978,206 New Mexicans through several programs including: the Medicaid Program, Temporary Assistance for Needy Families (TANF) Program, Supplemental Nutrition Assistance Program (SNAP), Child Support Program, and several Behavioral Health Services.