Yes I have called them but they just said to apply again. They said nothing about reinstatement. I found out about that on the internet, asking questions. I'm just afraid how long it will take , due to her condition.
Whomever is moms DPOA needs to file an appeal ASAP. Usually in an ineligibility notice there should be listed the reasons why and a page on appeals process and timeframe. I'd suggest you do this via a certified letter sent uspo with the return registered card (about $8.00 for the duet) AND via fax from a FedExKinkos or other office store that can provide a transmission report on the fax.
Keep it short like under a page and that you need further clarification on documents needed.. Or whatever else sounds appropriate. Hopefully this buys you some time. I'd do both fax & a mailing.
? for you? What is moms Medicaid contact address? If moms in a facility & it's going there that is recipe for problems as the NH cannot open her mail and letters just get buried into a drawer. If mom as dementia, who know what happens.... All needs to go to whomever is moms DPOA at their current address. If moms application was done ages ago, it could be a bad address is still lingering in her state file.
If you just got this notice (like March), I'd bet it's a snafu on 2 things... - awards letters & - annual recertification. That combined caused her to become ineligible.
Awards letters are a trifold that get sent from SSA and most other retirements that state to the penny what the amount mom will be paid for the incoming year. Usually sent in Nov & Dec. Mucho importante as that is the figure used to determine if moms monthly income is under the limit for Medicaid AND the amount of $ mom must pay to the facility as her required co-pay or SOC (share of cost). If mom went from a community based Medicaid program (so she was still at home) to a facility the income limits can change for eligibility. Plus she MUST do the copay to the penny. Pause to think if there could be an issue with the income in her awards letters.
Annual recertification. Some states do these so that it's an actual multipage document that is mailed & must be completed and submits with supporting documentation. Documentation for my moms was both things submitted in inital application (like funeral policy & life insurance) and then updated items like last 4 mos of bank statements (probably to make sure no assets over 2k) and last tax assessor bill (my mom continued to keep her home). I had no idea there was an annual recert done. I'd either boxed up all paperwork on my moms application or shredded stuff..... Then about 16 mos after my mom was in a NH, I got the recert letter as I was on file as her DPOA and it required all to be submitted and within 15 days from date of letter otherwise ineligibility could be placed. FUN! It was about an 8 page questionnaire and with supporting documentation around 30 pages total. For extra fun in this, letter was postmarked about 10 days after date of letter. This pattern of the recert letter being received basically when it was due back....... continued for every recertification for my mom. For year 2 I was totally ready.
It could be if your mom qualified years & years ago, that the state has finally got around to doing a recertification. If the mailing was sent to her or to a bad address, it never got done. So mom became ineligible.
Personally I've found calling the State at the general 800 # just doesn't matter. You need to send things via fax or certified mail as it provides for proof that things were requested or done. It places responsbility upon the state to correctly have the request or documentation go to the right department or section.
BJM - I was kinda assuming that mom's in a NH..... But if not & living at home & is on hospice fairly recently, it could be that her medical costs are viewed as now totally paid for by Medicare. Hospice is a Medicare benefit, so it should pay for caregivers, equipment, speciality nutionals.......needed. Hospice MD is now her doctor. Only if she needed to see a doctor for something outside of hospice care would she need Medicaid, like she sees her old ophthalmologist for glaucoma. The problem may be related to hospice taking over all care. It's something to put into the letter / fax you send.
Now Medicare does NOT pay for any room & board charges, so if mom was in a NH, she would need Medicaid to pay her daily R&B charge. But your moms at home, so that's not an issue.
As an aside on this,my mom was in a NH for about 3 years and fell (pulling her wheelchair no less!) so became bedfast and went onto hospice. Stayed at NH with Medicare hospice benefit paying all medical costs AND Medicaid paying her R&B for her last 18 months. There was a shift in costs of RXs and supplies from Medicaid to Medicare once on hospice. I mention this as perhaps IF hospice is recent, Medicaid has shifted costs they paid to Medicare.
Also hospice as its Medicare, is self-directed. Which means mom or you as her DPOA can change providers. I did with my mom's within her first 90 day period. First hospice really took the position of its a count down till death approach. My mom was a tough tiny old bird and I knew she wasn't going anywhere soon. Switched hospice providers and it was a big, big, bigly difference. Both got the same rate paid by Medicare but #2 really got on it... Ordered Geri bath & Geri regular chairs, a on variable timer puffing mattress, Twin Cal HC drinks, feeding bibs and met with dietary to get changes done amoung a host of other things. My point is, mom can change hospice if you think she could get better care.
Keep it short like under a page and that you need further clarification on documents needed.. Or whatever else sounds appropriate. Hopefully this buys you some time. I'd do both fax & a mailing.
? for you? What is moms Medicaid contact address? If moms in a facility & it's going there that is recipe for problems as the NH cannot open her mail and letters just get buried into a drawer. If mom as dementia, who know what happens.... All needs to go to whomever is moms DPOA at their current address. If moms application was done ages ago, it could be a bad address is still lingering in her state file.
If you just got this notice (like March), I'd bet it's a snafu on 2 things...
- awards letters &
- annual recertification. That combined caused her to become ineligible.
Awards letters are a trifold that get sent from SSA and most other retirements that state to the penny what the amount mom will be paid for the incoming year. Usually sent in Nov & Dec. Mucho importante as that is the figure used to determine if moms monthly income is under the limit for Medicaid AND the amount of $ mom must pay to the facility as her required co-pay or SOC (share of cost). If mom went from a community based Medicaid program (so she was still at home) to a facility the income limits can change for eligibility. Plus she MUST do the copay to the penny. Pause to think if there could be an issue with the income in her awards letters.
Annual recertification. Some states do these so that it's an actual multipage document that is mailed & must be completed and submits with supporting documentation. Documentation for my moms was both things submitted in inital application (like funeral policy & life insurance) and then updated items like last 4 mos of bank statements (probably to make sure no assets over 2k) and last tax assessor bill (my mom continued to keep her home). I had no idea there was an annual recert done. I'd either boxed up all paperwork on my moms application or shredded stuff..... Then about 16 mos after my mom was in a NH, I got the recert letter as I was on file as her DPOA and it required all to be submitted and within 15 days from date of letter otherwise ineligibility could be placed. FUN! It was about an 8 page questionnaire and with supporting documentation around 30 pages total. For extra fun in this, letter was postmarked about 10 days after date of letter. This pattern of the recert letter being received basically when it was due back....... continued for every recertification for my mom. For year 2 I was totally ready.
It could be if your mom qualified years & years ago, that the state has finally got around to doing a recertification. If the mailing was sent to her or to a bad address, it never got done. So mom became ineligible.
Personally I've found calling the State at the general 800 # just doesn't matter. You need to send things via fax or certified mail as it provides for proof that things were requested or done. It places responsbility upon the state to correctly have the request or documentation go to the right department or section.
Now Medicare does NOT pay for any room & board charges, so if mom was in a NH, she would need Medicaid to pay her daily R&B charge. But your moms at home, so that's not an issue.
As an aside on this,my mom was in a NH for about 3 years and fell (pulling her wheelchair no less!) so became bedfast and went onto hospice. Stayed at NH with Medicare hospice benefit paying all medical costs AND Medicaid paying her R&B for her last 18 months. There was a shift in costs of RXs and supplies from Medicaid to Medicare once on hospice. I mention this as perhaps IF hospice is recent, Medicaid has shifted costs they paid to Medicare.
Also hospice as its Medicare, is self-directed. Which means mom or you as her DPOA can change providers. I did with my mom's within her first 90 day period. First hospice really took the position of its a count down till death approach. My mom was a tough tiny old bird and I knew she wasn't going anywhere soon. Switched hospice providers and it was a big, big, bigly difference. Both got the same rate paid by Medicare but #2 really got on it... Ordered Geri bath & Geri regular chairs, a on variable timer puffing mattress, Twin Cal HC drinks, feeding bibs and met with dietary to get changes done amoung a host of other things. My point is, mom can change hospice if you think she could get better care.