Blog Series Part 3: Medicaid Application Process

When a client walks into my office seeking advice on how to obtain Medicaid benefits for long term care, they typically have just learned that their loved one’s Medicare skilled nursing benefits are about to be terminated and the nursing home simply gave them a blank Medicaid application to complete with no other guidance.  However, an elder law attorney experienced with Medicaid planning should be able to guide you through the process easily from beginning to end.

The application form is called the PA 600L and can be found online or obtained from the nursing home’s business office.  It has 15 sections, each requiring different types of supplementary verification documentation, but not every section applies to every applicant.  The first required document is something called the MA 51 Options Assessment, which is simply a confirmation that the applicant requires long term nursing care, completed by the nursing home.

The next step is to begin gathering all of the documents required to prove the information listed in the application itself.  This includes paper verification of the applicant’s identity including proof of birth like a driver’s license or birth certificate, and a social security card.  It also includes documentation related to the applicant’s current health insurance coverage and health care costs, such as copies of insurance ID cards and recent medical bills.  If the applicant still owns a home or other assets such as insurance policies, a vehicle, or investments, then supporting documentation like deeds, mortgages, burial plots and account statements are required.  Proof of all income also must be provided, such as that year’s Social Security statement or documentation of all other income such as pensions or annuities.

Often, the most overwhelming part of the application is the section requesting statements of all bank and investment accounts that the applicant has owned in the last 5 years.  Most people are shocked to find out that the state truly will review financial transactions going back that far looking for unauthorized transfers.  If the applicant has a spouse remaining in the community, there is yet another layer of required documentation related to the spouse’s financial situation.  It is not uncommon to submit a stack of supplementary paperwork with the application that is well over an inch thick.

The application may be submitted up to 90 days after the date on which benefits are requested to begin.  The approval process itself can take several weeks and often includes multiple follow-ups with the assigned caseworker, who often requests additional information to complete their review.  It can be a long, arduous process, however, an effective elder law attorney should be able to assist you in pulling together an application which has a greater likelihood of being approved quickly by avoiding commonly made mistakes and pitfalls.

This blog post was originally created by Joellen Meckley while she served in an “Of Counsel” position in our firm. While she no longer does that, we do maintain a  professional relationship and if you have any Elder Law needs, I’d recommend you reach out to her firm Meckley Law. If you need Estate Planning, please reach out to us.

 

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