Many doubts still persist among users about the process of renewing their medical coverage.
October 22, 2023
Since April 1 of this year, the recertification process for the beneficiaries of the Government of Health Plan began. Puerto Rico known as Plan Vital and beneficiaries of the Medicare Advantage Platinum program.
Precisely during the ‘Health in Your Hands’ Forum led by Medicine and Public Health Magazine, officials from the Medicaid Program and the Health Insurance Administration of Puerto Rico (ASES) clarified doubts about the recertification process that 1.6 million beneficiaries of the Plan Vital.
All beneficiaries must renew their medical coverage
“Recertification began on April 1. As with any federal program, people must renew annually for the program to ensure they qualify for these benefits. Puerto Rico Since 2017 it has not gone through this process and with the end of the COVID-19 emergency we have the federal mandate to recertify all beneficiaries of the program,” reported Dinorah Collazo Ortiz, director of the Medicaid Program.
See the full forum here.
The Department of Health Puerto Rico It had several service channels for Puerto Ricans to complete the recertification process that will be valid until April 2024. These include: Plan Vital; contact via email; telephone call to the insurer and delivery of physical documents to the offices provided by Medicaid.
Medicaid and Medicare Advantage Platinum Renewal
“The Medicaid eligibility and recertification process is applicable to Vital Program participants. However, we also have a population that goes through this same process which is the Medicare Advantage Platinum population. “They are people with conditions of particular need and have an economic index, who, having contributed part A and part B of Medicaid, can enroll in a Medicare Advantage Platinum Plan, that is, the costs of that plan are in accordance with their financial reach.” , explained Roxanna Rosario.
The Executive Director of ASES mentioned that one of the advantages of the Medicare Advantage Platinum program is that “they have almost no co-payments” and they have several supplementary services according to the health needs of the beneficiaries.
Currently, there are nearly 300 thousand people in Puerto Rico who have the Medicare Advantage Platinum Plan, in addition to the nearly 1.6 million users of the Plan Vital of the Government of Puerto Rico.
“Recertification is being done for both groups. In fact, there are people in the Vital Program who did not pay part B of Medicaid and even though they have an economic situation that qualifies them, they cannot apply for Medicare Advantage Platino,” Rosario clarified.
How can you be part of the Vital Plan?
Currently, to be eligible for Plan Vital of the Government of Puerto Rico. The income of the person is taken into account, who is an American citizen and a resident of Puerto Rico in addition to other requirements that are required during the process, such as the registration form, identification document, social security, among others.
“On the Medicaid page the person can complete their documents or also through the Vital App. If you are already a beneficiary and are recertifying, you will receive a letter that you have to renew and you can complete that form through mail or in our offices,” said Collazo Ortiz.
Medicaid has different communication channels to keep users informed about the certification process. However, if the person has questions about how the procedure is carried out, they can communicate through the plan’s website, by telephone or social networks.
“If a beneficiary is not sure what is happening, the easiest thing they can do is call us at 787-641-4224 and there they can be guided to see when their coverage expires and when they can begin to process it,” he stated. the Atty. Esdras Vélez.