Two important developments have happened since the November elections. First and foremost for the majority of Fra Noi readers, one of the likely things on President-elect Trump’s to-do list is the block granting of Medicaid. Medicaid is the premier federal and state joint government program that pays for long-term care for seniors in nursing homes along with a host of other societal needs. While one of Trump’s campaign promises was repealing Obamacare, his election coupled with the Republican control of both the House and Senate means that there will almost certainly be a new GOP effort to convert the …
Read More »Medicaid eligibility requirements
Applying for Medicaid for long-term care in a nursing home is a complicated matter. This article will limit itself to describing the basic eligibility requirements. The eligibility requirements break down into four categories. Medical Eligibility First you have to demonstrate that you meet the Determination of Need score, also known as the DON score, which establishes whether or not someone actually requires long-term care in a nursing home. This assessment may be administered by Catholic Charities, nursing homes, and many other organizations. Income Eligibility The income eligibility requirement is to determine if your income exceeds the private cost of care. …
Read More »First comes the application, then comes the audit
In the previous section of our 10 part series, we talked about preparing and filing the Medicaid application. Once that application is filed, a new challenge will present itself. One or two months after the submission of the application to the Department of Human Services, the approved representative for the Medicaid applicant will receive a call from either the DHS caseworker or the caseworker for the Office of the Inspector General, depending on where the application is being audited. The approved representative will then be asked to submit additional documentation that the caseworker feels is necessary to complete the application. …
Read More »Preparing and filing the Medicaid application
The Medicaid application process involves many steps generally described as follows: 1) Projecting Medicaid eligibility by categorical reference 2) Establishing eligibility based on countable assets and exempt assets 3) Determining income eligibility 4) Establishing the treatment of transfers and penalty periods that are result of the Medicaid applicant’s history 5) Anticipating whatever estate recovery and lien rules there may be and then applying them. Illinois Department of Human Services and Healthcare and Family Services websites have a list of documentation that applicants are to gather. For example, you’ll need to provide 60 months of statements for all accounts, copies of …
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