Q4 2021 Eligibility Update

Get ready to help more patients with these important changes to eligibility criteria. Stay up to date with PointCare.

Assist More Members with Food and Nutrition Services 

Known by several names including the Food Stamps program, Food Assistance Program, and more, SNAP is a federal program administered by the Department of Agriculture. The program provides food-purchasing assistance for low or no-income households. Approximately 10% of Americans benefit from this program yearly. In Q3 2021, the program relaxed its Asset Limits, which means more people can now qualify for the program. 

Summary: SNAP Asset limits increased by around 10%, meaning more people now qualify.

Support More Disabled Floridians with Relaxed Eligibility Rules 

The Working People with Disabilities legislation of 2019 allows disabled individuals who are enrolled in certain Medicaid Waiver programs to enjoy increased Asset and Income limits while still being enrolled in Medicaid. 

Considering that 26% of US residents have at least one form of disability, this program can help benefit many individuals.

Summary: Florida Medicaid has increased the Income Limits of the Working Disabled from 300% FBR to 550% FBR. Asset limits have also been increased by a multiple of 6-8.

Take Advantage of Extended Coverage for your Postpartum Patients 

42% of all U.S. Births in 2020 were covered by Medicaid. Federal rules also provide Medicaid coverage beyond birth, up to 2 months of postpartum. The American Rescue Plan Act of 2021 has a new provision to allow states to extend this coverage period from 2 months to up to 12 months. This will be in effect from April 2022 and can last up to 5 years (depending on the state's decision). So far, 21 states have acted on this, giving full 12 months coverage, while 5 other states have adopted this with shorter limits such as 6 months or 3 months.

Summary: Medicaid has increased its pregnancy postpartum coverage from 2 months to up to 12 months (depending on the state).

New Major Programs in the PointCare System

PointCare continues to expand our program database to help you offer more options to your patients. Check out two major programs we have added to our system in the last quarter. 

Inform Your Medicaid Eligible Patients About Sponsored Private Insurance Options: HIPP (Health Insurance Premium Payment Program) 

The HIPP program is a Medicaid program that allows recipients to receive private health insurance sponsored by the State’s Medicaid. The program was put into place for those cases where the monthly cost of premiums for a private health insurance plan is less than the monthly expenses for providing Medicaid coverage (“cost-effective” scenarios). The rules are based on Medicaid eligibility, with the condition that a household member can receive private insurance through work. 

Summary: HIPP programs have been added for several states. This will cover the cost of premiums for private health plans.

Help Low-Income Families with Child Care Subsidies: Child Care Assistance

Each state receives funds from the federal government for a state-run child care subsidy program. These programs help low-income families pay for child care so they can work or attend school. Eligibility and income requirements vary by state. Visit the state resources section to find information about each state’s program.

Summary: Child Care programs, which provide state-run child care subsidies for low-income families, have been added to the system.

How Does PointCare Help?

These updates and more are already included in our software. 

PointCare ensures a standardized and data-driven qualification process. Using our nationally curated database of all insurance and benefit programs nationwide, team members know that they are sharing up-to-date information with patients. Once this 90-second screening is complete, the patient can receive results via email, text, or print. 

PointCare is now offering Qualify API as a standalone product in addition to our Total Enrollment Management platform. Request a demo.