Disclaimer: With Medicaid, VA, and insurance regulations frequently changing, past blog posts may not be presently accurate or relevant. Please contact our office for information on current planning strategies, tips, and how-to's.
The last stage of completing a Medicaid crisis plan is submitting the Medicaid application. Completing and filing the Medicaid application can be a cumbersome and tedious process. To help alleviate some of the confusion, we wanted to share some tips with you regarding completing and submitting the Medicaid application to ensure your client can receive the benefits they need.
Obtaining the Application:
While each state may have its own unique application forms, the information that is being requested is essentially the same. To begin, you will want to determine whether your client can submit the Medicaid application online or if they must complete a paper copy of the application. You should be able to obtain this information from your local Medicaid agency as well as a copy of the most current application.
There is no restriction as to who can complete the Medicaid application, however, it is commonly completed by the applicant or their spouse. If the applicant or their spouse is unable to complete the application, the application can be completed by a legally appointed representative of the applicant such as a power of attorney or conservator.
Completing the Application:
When applying, there are quite a few documents that need to be included to help verify the applicant’s financial information. Some of the documents may include copies of pay stubs, Social Security statements, bank statements, the deed to any property owned within the last five years, retirement account statements, vehicle registration, and copies of any prepaid funeral contracts or burial plots. This list is not exhaustive and even when all of these supporting documents are supplied, the caseworker may still request additional verification documents.
In addition to documentation proving the applicant’s assets, income, and expenses, they will also be required to present proof of citizenship and to verify their identity. Government-issued documents such as a passport, driver’s license, or a state-issued identification card can help verify the applicant’s identity and citizenship.
Submitting the Application:
Compiling these statements from the previous five years can be a time-consuming process. As such, some applicants may submit the application without including the supporting documents. Once the application is received, a Medicaid caseworker will establish a deadline date by which all the requested information must be submitted. This will give the applicant some additional time to locate these statements without having to delay the submission of the application.
If your client engaged in any asset preservation strategies such as purchasing a Medicaid Compliant Annuity or an irrevocable funeral expense trust, it is important to indicate these purchases for the caseworker. Often a cover letter accompanying the Medicaid application can be useful in summarizing to the caseworker how the funds were repositioned to fund an exempt asset. It is important to make sure that your client is disclosing all necessary information on the Medicaid application and not intentionally concealing assets. Clients who intentionally withhold asset information in an attempt to defraud Medicaid may incur a substantial fine as a result.
Timing the Application:
Depending on which county your client resides in, will determine the local Medicaid agency that you should apply to. If you cannot apply online, you do have the option to either mail or hand-deliver the documents to the local agency. In practice, most attorneys prefer to hand-deliver the application to the local agency. This can help ensure that you have a time-stamped receipt of when the application was physically received by Medicaid should there be any questions as to when the applicant’s benefits should commence.
Timing the submission of the Medicaid application correctly can be crucial to your client receiving benefits when they anticipated. You will want to make sure that your client meets the financial eligibility standards before submitting the Medicaid application. Since Medicaid is a month-by-month system, the applicant can begin receiving benefits in the month they are deemed eligible. As such, it is important to file the application in the month during which coverage is needed to begin and as soon as eligibility has been achieved. However, in some instances, your client may be able to request retroactive benefits for at least three months prior to submission, assuming they met and maintained all asset eligibility requirements during that time.
Reviewing the Application:
Depending on the state, and sometimes the county, the length of time it may take to review and approve a Medicaid application can vary. Once the application has been reviewed, your client will receive a notice from the Medicaid agency either approving or denying the request for benefits. If your client receives an approval letter, Medicaid has determined the client meets all eligibility requirements and should be receiving benefits shortly. However, keep in mind that Medicaid does require that applicants complete an annual renewal process. As such, additional documentation may need to be completed and submitted to Medicaid during that annual reevaluation.
If your client receives a denial letter, you and your client should review the reason for the denial. The basis for the denial should be included in the notice received by the applicant and can be based on a variety of reasons. Sometimes, the denial can be remedied without any additional court action by resending information that the caseworker may have overlooked or providing greater detail and explanation of the client’s spend-down strategy. However, if you are unsure whether you will be able to remedy the denial swiftly, it is best to immediately utilize the client’s right to request a fair hearing. This allows the client to secure this time for them to appeal the caseworker’s denial before an Administrative Law Judge and can always be removed if the matter can be remedied before the scheduled hearing.
As noted above, the Medicaid application is complicated and can be time-consuming. The client’s asset preservation strategy and application submission must all be timed perfectly to ensure benefits commence when desired. As such, it is highly recommended that clients consult with an elder law attorney that specializes in Medicaid planning to ensure their eligibility.