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.
At the end of every Medicaid plan comes the Medicaid application. Although each state has its own application, the overall process for filling it out remains consistent. Let’s dig into the process of preparing and completing the Medicaid application, including the importance of full disclosure and timing.
Choosing the Applicant
The first step is choosing who will fill out the application. In many cases, this will be the Medicaid recipient, but the community spouse may also complete the application. If the applicant is single and unable to fill out the application on their own, it may be completed by a legally appointed representative, such as a power of attorney, legal guardian, or conservator.
Completing the Application
The next step is accessing the Medicaid application and filling it out. Most states offer a paper application to be filled out by hand, but some states may also offer the option to complete the application and submit it online.
What Information Needs to be Included?
As mentioned, each state has its own Medicaid application form. Despite slight differences, each state Medicaid agency will ask for the same basic information about the applicant’s assets, income, expenses, and transfers during the lookback period. Along with this information, the applicant will also have to provide proof. This may require the need to extend certain sections beyond the space provided. In these cases, you’ll want to make sure your client clearly indicates the continuation of information. Likewise, your client should also include explanations for any large repositioning of assets, such as Medicaid Compliant Annuities and Funeral Expense Trusts.
When filling out the application, it’s important that your client is as precise and specific as possible without providing any unnecessary information, such as transfers outside of the lookback period. The key is to clarify any confusing areas in order to avoid the ambiguity that may result in confusion by the caseworker. You’ll also want to make sure your client is disclosing all of the information they have and not intentionally hiding assets. If they purposely fail to provide full disclosure of their assets, income, and divestments, they risk incurring a hefty fine.
The Timing of the Application
As with every step of the Medicaid planning process, the timing of the application is crucial. Medicaid is a month-by-month system, so if eligibility is established in a particular month, the applicant may receive benefits for that month and forward. Therefore, it’s important to file the application in the month during which coverage is needed to begin and as soon as eligibility is achieved. Although your client may qualify for retroactive coverage up to three months before the application is submitted, you want to file the application as soon as possible. The retroactive application should only be used as a short-term bridge in the event the application is delayed until the beginning of a new month.
Since the Medicaid application requires so much documentation, it can take some time to gather everything. Your client may choose to file the application as soon as possible with whatever documentation they have available at that time. Or they can choose to file the application by itself and provide all supporting documentation at a later date. Either way, the caseworker will provide a deadline for all application documents to be submitted. Once everything is filed, you’ll want to establish an acceptable snapshot date with the caseworker. This can help ensure the timing is met on their end.
Medicaid Denials and Fair Hearings
In some cases, whether due to an application error, missed deadline, or something else, your client’s application may be denied. Fortunately, they have the right to appeal the adverse ruling and request a fair hearing. To learn more about Medicaid denials and fair hearings, check out our Industry Insights video series, specifically Overcoming Denials and Fair Hearing Support and Common Mistakes in the Fair Hearing Process. You may also want to download our comprehensive Medicaid Denial and Fair Hearing Guide, which is available through your Attorney Access account.
If you have any questions about completing the Medicaid application or any part of the Medicaid planning process, feel free to reach out to our team at Krause Financial.
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