Many new Medicaid enrollees in the dark about benefits, MACPAC hears

Newly enrolled Medicaid beneficiaries are receiving little to no guidance from states or managed-care plans regarding the scope of services they're eligible to receive, according to focus group findings prepared for the Medicaid and CHIP Payment and Access Commission (MACPAC).

To date, 27 states and the District of Columbia have expanded Medicaid to individuals earning between 100% and 138% of the federal poverty level under guidelines in the Patient Protection and Affordable Care Act.

As of August, 7.2 million people have signed up for Medicaid or the Children's Health Insurance Program since exchanges opened last October, according to the CMS.

But once these individuals enroll, they don't know what to do next in terms of obtaining healthcare services, researchers from PerryUndem Research/Communication say. They conducted six focus groups with new beneficiaries in Oregon, Colorado and Illinois to develop their report.

“There is a problem now, where people are newly enrolled, but they don't understand coverage limits,” said Michael Perry, partner at Perry Undem Research/Communication. “There is a big information gap out there.”

Some new enrollees received pamphlets with information, or were directed to websites, but for the most part, many of those interviewed had gotten no information, he said.

One challenge for many is finding a primary care physician. “It's not just there aren't enough, it's that they just don't know how to do it,” Perry said.

Another issue is that many didn't know that Medicaid doesn't cover dental benefits, a key reason many sought coverage.

Recently states such as Illinois and Colorado, have re-introduced, or introduced for the first time, dental services for adult Medicaid beneficiaries. As many as 8.3 million Medicaid beneficiaries will become eligible for dental benefits this year, according to an analysis by the American Dental Association.

However, most other states don't offer these benefits due to cost concerns.

Follow Virgil Dickson on Twitter: @MHvdickson