Disclaimer: With Medicaid, VA, and insurance regulations frequently changing, past blog posts may not be presently accurate or relevant. Please contact our office for information on current planning strategies, tips, and how-to's.
At the end of every Medicaid plan comes the Medicaid application. Every state has its own specific application, but the process for filling it out and the information required remain consistent. Let’s explore the process of completing the Medicaid application as well as the importance of full disclosure and how timing can affect your client’s case.
Who is the Applicant?
Before you begin, you’ll want to choose who will complete the application. In many cases, the applicant will be the Medicaid recipient, but the community spouse may also complete the application. If the Medicaid recipient is single and unable to fill out the application on their own, it may be done by a legally appointed representative, such as a power of attorney, legal guardian, or conservator.
Filling Out the Application
The next step in the process is accessing the Medicaid application and filling it out. The majority of states offer a paper application to be filled out by hand, but some states also offer the option to complete the application online and submit it digitally.
Information and Supporting Documentation
Although each state has its own specific Medicaid application form, they all ask for the same basic information about the applicant’s assets, income, expenses, and transfers during the five-year lookback period. All of this information must be accompanied by proof in the form of supporting documentation. As such, some sections will need to be extended beyond the space provided, in which case you’ll want to make sure your client clearly indicates the continuation of information. Likewise, your client should also include a cover letter with detailed explanations for any large repositioning of assets, such as Medicaid Compliant Annuities and Funeral Expense Trusts.
During the Medicaid application process, your client should be as precise and specific as possible without including any needless information, such as transfers outside of the lookback period. It’s important for them to clarify any complex details in order to avoid ambiguity that may confuse the caseworker. You’ll also want to make sure your client discloses all of the information they have. If they intentionally hide assets or purposely fail to provide full disclosure, they risk incurring a hefty fine.
The Timing of the Application
Much like every other step of the Medicaid planning process, the timing of the application is crucial. Since Medicaid is a month-by-month system, the applicant begins receiving benefits during the month in which eligibility is achieved and forward. Therefore, it’s important to file the application in the month where your client needs their coverage to begin and as soon as they achieve eligibility. In some cases, your client may qualify for retroactive coverage up to three months before the application is submitted, but this option should only be used as a short-term bridge in the event the application is delayed until the beginning of a new month. In other words, your client should file the application as soon as possible.
Since the Medicaid application requires so much documentation, it can take quite a bit of time to gather everything together. You have a few options for filing the application. You may choose to submit it as soon as possible with whatever documentation you have available at that time. Or you can file the application by itself and provide all supporting documentation when everything is available. Either way, the caseworker will provide a deadline for all application documents to be filed. Once everything is submitted, you’ll want to work with the caseworker to establish an acceptable snapshot date. This can help ensure the timing is met on their end.
Medicaid Denials and Fair Hearings
In some cases, your client’s application may be denied. This can be due to an application error, missed deadline, or some other reason. Fortunately, they have the right to appeal the unfavorable ruling and request a fair hearing. We recommend working with an elder law attorney throughout the Medicaid planning process but especially in the event of a Medicaid denial or fair hearing. If you’d like to learn more about working with an attorney, log in to your Agent Access account to download our white paper on Improved Techniques for Approaching Elder Law Attorneys.
If you have any questions about completing the Medicaid application or any part of the Medicaid planning process, feel free to reach out to our team at The Krause Agency. We can also help get you connected to an elder law attorney in your area.