New Eligibility Assessment Leaves Resident Ineligible for Certain Benefits

elderly man in wheel chair

Disclaimer: Since Medicaid rules and insurance regulations are updated regularly, past blog posts may not present the most accurate or relevant data. Please contact our office for up-to-date information, strategies, and guidance.

Arkansas implemented a new eligibility assessment tool this year that has created havoc for many senior residents that are now no longer eligible for Medicaid benefits. Of 331 assisted-living residents who had been assessed by this new tool, 146 were found to be ineligible. Nearly half of those 146 residents were found to be eligible in previous years, before this new tool was implemented.

If found ineligible, residents can file an appeal. If they are still found ineligible for assisted living or in-home care benefits, they still may be eligible for other Medicaid benefits, like nursing home care.

Critiques of this new tool say the assessment has produced different results after being taken again by a number of residents. They also say that the classification of certain illnesses or abilities has changed and the nurses often downplay the extent of the applicant’s disabilities.

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