General Discussion of the Medicaid Application Process

General Discussion of the Medicaid Application Process

In applying for institutional Medicaid, there are two basic documents that I present to my clients at the initial meeting. One document is a list of information required by the respective County Board of Social Services. For purposes of simplicity, this article shall relate to a single individual.

I. Typical information requested by a county board might include:

1. proof of age.
2. proof of citizenship.
3. proof of identity (such as driver’s license).
4. proof of marital status.
5. proof of residence.
6. proof of current gross income, which would include pension, social security, veterans benefits, earnings.
7. income tax returns for three years.
8. closed out accounts for the past period of time. The amount of time currently being reviewed by Medicaid increases each month with the initial month being February, 2006, so that for March, 2009, 37 months are reviewed and for April, 2009, 38 months would be reviewed.
9. life insurance policies.
10. prepaid funeral contract (if applicable).
11. health insurance ID information.
12. deed to house (if one is owned).
13. copies of nursing home bills.
14. social security and Medicare cards.
15. power of attorney (if applicable).

II. The second document that I present to the client is the application.

1. The application asks for clarity on much of the information discussed above, but includes questions such as transfers made during the aforementioned respective time periods.

2. Personal information relating to name, veteran status, history of residence, specific asset information, whether you are the beneficiary of someone’s insurance policy, pending lawsuits, medical coverage. Posts that discuss the information in detail are life insurance issues (Post 3), qualifying for Medicaid (Post 16).

III. At the initial meeting I discuss the facts to see if there are any obvious planning possibilities such as surrendering life insurance (Post 3), applicant residing with a caretaker child (Post 6), rules of Medicaid eligibility are reviewed (Post 7), resource limitations for community spouse not limited after applicant receives Medicaid (Post 13), whether a dependent relative resides in the house (Post 14), new transfer rules effective February, 2006 (Post 15), possibility of payment by applicant for care or services provided by child (Post 17), inadvertent disqualification of applicant (Post 21), methods of accelerating Medicaid eligibility (Post 4, 5, 7, 10, 12, and 20).



Disclaimer: This article does not constitute legal advice and each person may have unique facts for which legal consultation may be necessary.


© July 2009, Post 47

Date of Application Could Be Fatal

Date of Application Could Be Fatal

Usually, the date of eligibility is easy to project. As indicated above, application should be made several months prior to the anticipated date of eligibility. Therefore, after submission of the required documents and financial information to Medicaid, only subsequent monthly financial data need be submitted until eligibility is granted. That is, in the usual case early application is part of a prudent planning process. However, in terms of the date of eligibility, early application could be fatal when there have been transfers.

A. The look-back period is 60 months prior to the date an individual is institutionalized and has applied for Medicaid.

B. If an individual delays applying for Medicaid until 60 months after a transfer, eligibility will be granted.

C. Suppose individual applies for Medicaid 56 months after transferring $200,000 to brother. Applicant is ineligible for Medicaid. Suppose individual applies five months later, which is 61 months after the transfer. Will the original application be fatal or will it be cured by the later application? The original application is fatal and is not cured by the later application. Medicaid will be denied.


Disclaimer: This article does not constitute legal advice and each person may have unique facts for which legal consultation may be necessary.


© April 2009, Post #25