Recent Trends with Medicaid Applications – Part 2

In my post last week I told you why I think Medicaid applications have become more difficult to get approved.  This week I will talk about the ways the State has made it more challenging.

One way, which I have written about several times over the past few months is the QIT requirement.  I won’t review that here but encourage you to read my post from 2 weeks ago.  There are, however, other changes that have occurred recently.

More documentation than ever is required to process a Medicaid application.  Routinely now, many counties require that we produce 5 years of an applicant’s credit card statements so they can examine the charges.  The State wants to determine whether any of the charges are for purchases made for someone other than the Medicaid applicant.  

Purchases for others would be subject to a Medicaid penalty, a period of time during which the applicant continues to be ineligible for benefits.  The greater the penalty the longer the period of time before the State has to pay out benefits.

In other instances the documents that were once enough to explain transactions are now no longer sufficient.  For example, a copy of a check from an insurance company for a property damage claim against an applicant’s homeowner’s insurance policy is no longer satisfactory.  In at least one case we had to produce paperwork from the insurance company detailing that the claim related to the applicant’s home.  The check wasn’t enough by itself.

It is also more important than ever to understand the Medicaid regulations and other related laws or work with an attorney who does.  For example, on more than one occasion an application in our office has been denied because the caseworker counted a custodial account that a client set up for a grandchild as an asset of the client.  It is not.  The account is owned by the minor grandchild.  The grandparent simply acts as the custodian, similar to a trustee.  We filed appeals and in each case the judge ruled in our favor since the law is clear on this point.

As I have told people for years obtaining Medicaid benefits is no “cakewalk”.  You must be prepared to slog through an arduous process.  It certainly is worth it, however, in pure dollar terms.  It could mean saving tens and in some cases hundreds of thousands of dollars in long term care costs.