Clear, Plain-Language Guidance for Medicaid Work Requirements

Medicaid redeterminations and work requirements are confusing. Our interactive guide helps members screen for exemptions, calculate their hours, and pull together the right proof to keep their coverage.

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Complex rules lead to lost coverage

Navigating Medicaid work requirements shouldn’t require a policy degree. Between calculating 80 monthly hours, understanding complex exemptions, and rapidly approaching deadlines, the administrative burden on members has skyrocketed.

1

Membership Churn

Nearly 70% of Medicaid coverage losses are procedural, caused by administrative confusion and paperwork barriers rather than actual loss of eligibility.

2

Financial Risk

When members lose their coverage, the whole system absorbs the cost. Disenrollment strips members of essential healthcare access, leaving health plans short on capitation revenue, providers burdened with uncompensated care, and CBOs overwhelmed by support requests.

3

Operational Strain on Staff

Navigating complex policy details bogs down case managers, social workers, and community navigators in endless administrative support instead of direct care.

Proactive guidance to prevent avoidable disenrollment

Our Seeker-Facing Redetermination Guide strips out policy jargon, screens for exemptions upfront, and provides clear, step-by-step guidance so members can prepare for renewal and protect their Medicaid coverage—all with minimal staff oversight.

The Findhelp Difference

Our guide turns complicated state policy into a clear, step-by-step roadmap—moving beyond static PDFs and generic online screeners so members know exactly what to prepare.

Upfront Exemption Screening

Upfront Exemption Screening

Identifies whether a member qualifies for mandatory statutory exemptions (such as medical frailty, caregiving, or specific populations) before requiring them to track hours.
Automated Hour & Income Logic

Automated Hour & Income Logic

Calculates complex 80-hour monthly rules, seasonal averaging, and part-time wages automatically to eliminate member confusion.
State-Specific Renewal Guidance

State-Specific Renewal Guidance

Delivers dynamic, localized instructions and document checklists tailored to individual state rules, ensuring members gather the proof required for their renewals.
Direct Network Access for Qualifying Activities

Direct Network Access for Qualifying Activities

Connects members directly to the nationwide Findhelp network to find local workforce development, job training, and education programs that count toward their monthly requirements.
Self-Service Member Roadmap

Self-Service Member Roadmap

Provides plain-language action steps that allow members to prepare independently, reducing phone calls and administrative burden for MCO care managers and CBO navigators.

The impact: Protecting coverage across the care continuum

When members are prepared before state deadlines hit, everyone across the safety net benefits:

For Health Plans (MCOs)

Safeguard monthly capitation revenue and prevent administrative member churn.

For Providers

Eliminate sudden coverage gaps that lead to uncompensated care and unpaid medical bills.

For CBOs & Navigators

Shift staff time from explaining complex policy rules to delivering direct community care.

Ready to simplify Medicaid redeterminations for the people you serve?

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