I have approximately 4 months to initiate this process before my mother's assets are spent down with self-pay at SNF. My brother and I (we are both POAs) have an appointment with an Elder Law Attorney soon.
Given each State is different, IMHO I would ask both the elder care attorney as well as the business office director at the nursing home, which approach they would advise. The nursing home business office folks generally have lots of experience and knowledge about their State/Local Medical office and the staff who handle things for approving Medicaid "long term nursing home" coverage for their facility.
We -- upon the advice of both the attorney and nursing home business person -- when with an on-line application as it was more efficient and desired in our State and w/the local Medicaid staffers. The nursing home can also upload documents into your State portal for you, assuming your State (most do) have the on-line application option.
Doing things on-line also helps downstream as there are "redeterminations" that are done annually (more paperwork to file) AND if there are any changes in coverage; once can see such notices faster on-line. For example, the amount of funds your loved one may keep (not much, like $80-90) each month; will change in July (at least in our State) and then on Jan 1., your loved one's "cost of care contribution" will also change based on any increase in their Social Security and/or pension/retirement payments.
All to say, the first application to qualify is just the start of on-going paperwork, filings and notices AND so much easier to do this on-line if possible.
It is better and quicker to apply online. After an Elder Law Attorney, see a professional Medicaid planner, application hopefully started by now, since complicated rules vary for each state where recipients live.
I recommend bringing your Medicaid documents directly to the office. They’ll scan them, provide a receipt listing submitted documents and the employee’s name, ensuring clarity and avoiding potential issues.
Personally I would do both because if somehow something goes amiss it will be beyond a total PIA to deal with. And do the mailing certified mail from the USPS for under $10. Well worth the cost for the peace of mind.
Also as a suggestion to anyone reading this, when you are doing the initial application get a binder going and place all the original documents into it. Then over the next year put all updates on those documents into it + anything new…… Like their bank statements, the 90 day statements from the Nh on their personal needs account, their “awards letters” for the incoming year from SSA and other retirements. Anything that pays them a 1099, like a dividend paid on an old life insurance policy that actually pays then a dividend or their bank acct pays interest as all those should be submitted in the annual renewal as they are resources. If they keep their home or car, then the annual tax collector bill on those. As all these or the info from these get submitted in the renewal to determine their overall status and determine the copay for the next renewal period.
I used a certified elder attorney that I had been using for several years. Each persons situation is different. I felt it was money well spent. I did the recertification the second year with the help of a few phone calls with the attorneys office and faxed the info. I hope I can do the third year on my own. This forum had given me a lot of general advice and one member in particular helped but I still had situations the attorney was very helpful with. My application was for my DH aunt. She has no one but the two of us and I was stressed to the max handling a flood in her home. I had made some incorrect assumptions on what was income and what was insurance benefit and how to manage her company life insurance and her 401. She ended up having more monthly funds on an ongoing basis than if I had done it myself. Not sure it would ever break even on the attorney charges, she won’t live that long, but that money had to be spent down and this way she gets to keep a little more of her monthly income. I wanted to add that my attorney does use the online portal. I didn’t when I did the recert. I had 150 pages to fax. I could have taken it to the Medicaid office. I plan to next time as it’s very close to her N.H. Also the portals may be different state to state so there is that aspect. Good luck. It’s a lot of work.
I didn't have to do a 3rd year for my MIL (in MN). I've not had to do it since and she's been on it since 2016. Honestly, I'm not sure why she automatically qualifies every year, but it's a relief. Maybe because she's not made any taxable income because she didn't have to file? Not sure. We just get a letter telling us she has qualifed and to pick out her coverage.
I've only applied for my MIL through snail mail back in 2016. Recently I created a portal access online so that I could make an address change for her. My perception is that the portal is limited in what it can do, but it you can do the entire application process digitally, I would do it that way. Once you apply you will get an answer in 3 months.
We -- upon the advice of both the attorney and nursing home business person -- when with an on-line application as it was more efficient and desired in our State and w/the local Medicaid staffers. The nursing home can also upload documents into your State portal for you, assuming your State (most do) have the on-line application option.
Doing things on-line also helps downstream as there are "redeterminations" that are done annually (more paperwork to file) AND if there are any changes in coverage; once can see such notices faster on-line. For example, the amount of funds your loved one may keep (not much, like $80-90) each month; will change in July (at least in our State) and then on Jan 1., your loved one's "cost of care contribution" will also change based on any increase in their Social Security and/or pension/retirement payments.
All to say, the first application to qualify is just the start of on-going paperwork, filings and notices AND so much easier to do this on-line if possible.
Also as a suggestion to anyone reading this, when you are doing the initial application get a binder going and place all the original documents into it. Then over the next year put all updates on those documents into it + anything new…… Like their bank statements, the 90 day statements from the Nh on their personal needs account, their “awards letters” for the incoming year from SSA and other retirements. Anything that pays them a 1099, like a dividend paid on an old life insurance policy that actually pays then a dividend or their bank acct pays interest as all those should be submitted in the annual renewal as they are resources. If they keep their home or car, then the annual tax collector bill on those. As all these or the info from these get submitted in the renewal to determine their overall status and determine the copay for the next renewal period.
I did the recertification the second year with the help of a few phone calls with the attorneys office and faxed the info. I hope I can do the third year on my own.
This forum had given me a lot of general advice and one member in particular helped but I still had situations the attorney was very helpful with.
My application was for my DH aunt. She has no one but the two of us and I was stressed to the max handling a flood in her home. I had made some incorrect assumptions on what was income and what was insurance benefit and how to manage her company life insurance and her 401. She ended up having more monthly funds on an ongoing basis than if I had done it myself. Not sure it would ever break even on the attorney charges, she won’t live that long, but that money had to be spent down and this way she gets to keep a little more of her monthly income.
I wanted to add that my attorney does use the online portal. I didn’t when I did the recert. I had 150 pages to fax. I could have taken it to the Medicaid office. I plan to next time as it’s very close to her N.H.
Also the portals may be different state to state so there is that aspect.
Good luck. It’s a lot of work.