Medicaid & Medicare Assistance

A lot of people associate Medicaid with either being poor (in dire need) or being elderly.

And while this is partially correct, Medicaid is not a one size fits all program.

Before we analyze the Medicaid program, it is important to note that there are other helpful programs out there, anywhere from Children’s program, old age pension, basic health insurance, among others. There is also basic Medicaid and Long-term Care. Each one has different qualifications.

Depending on your level of income, Medicaid can be a big help for someone who might need insurance. It can also be very useful for families who might be on an employer plan; but for them to be included in the plan, it costs an arm and leg. So basic Medicaid could be a great benefit for those families who are in dire straits regarding insurance.

Basic Medicaid can also provide vital assistance to pregnant women, the elderly and people with disabilities.

The Long-term Care Medicaid Program will also not only assist with insurance, but can also pay for living arrangements such as group homes, memory care, nursing homes, skilled nursing facilities, institutional care as well as home care.

Within the Long-term Care Medicaid Program is a program called Home Community Based Services (HCBS) waiver. This will allow services to come to your home for home care, compassion care, some transportation, among other care services. In order to qualify, you have to be under the $2,250 income level; but should you have more income, there are ways in which you can still qualify for services. These ways include Income Trusts, Disability Trusts, Annuities which are considered a non-countable asset for the purpose of qualifying for Medicaid. Don’t worry if this all sounds a bit confusing. I can help you sort it all out.

Please remember this is only a partial list of ways and avenues to qualify for Medicaid. There will be another section that details additional ways.

There are some basic guidelines to getting qualified. Once you fill out the application and supply the Medicaid Administration with all the necessary documentation, you will then be subject to a Financial and Functionality review.

Functionality

The Functionality part is where the Colorado Access Representative will come out to your home and assess your needs, which will determine what type of services you can have as well as for how long. They will consider how well you perform in doing your Activities of Daily Living. If you are having difficulty with two or more of these activities, then you should be approved for additional support.

Once you get approved, your challenges are not over. Additional challenges arise in finding the right provider, as well as those that accept Medicaid clients. I can help you sort through these issues as well.

Financial Review

This is where the Medicaid Administration will review and determine if your financial information you supplied to them qualifies you for Medicaid. They will scrutinize everything, including all of your assets so don’t give false information as they will find out.

Qualification for Individual: Income can be no more than $2,250 per individual. (But don’t worry if your income is over the limit somewhat as there are ways of bringing your “countable” income down.)

Also remember that there are numerous items that are considered non-countable for Medicaid purposes. For example, house under $525,000, a car, burial plans… to name a few.

There is a mandatory 5-year “look-back” for any transfers, gifts or any other types of moving your money around that is not linked to a non-countable asset.

Depending on any overages they might find, the Medicaid Administration will require a penalty to be imposed. This penalty calculation uses the overage dollar number divided by the average cost of a nursing home stay. This determines your penalty/monthly wait time until you can get on Medicaid.

I can also help you sort through issues involving such complexities as:

  • Estate Recovery
  • Methods to Protect Your Assets
  • Locating High Quality Medicaid Providers?

The way I work with clients in getting Medicaid is by assisting them in filling out the application, provide them with a list of documents that are needed and help them in acquiring them. Once I get all the necessary documents together I than will make copies of them and personally drop them off to both state and county departments. By doing this I make sure that they have been received and get them time stamped which will start the process that day instead of waiting until they get to them via fax,email or scanned over to them. The reason is that they use the time they receive them to start the clock ticking. which enables me to have a quicker turnaround for my clients. I also do all the follow up with the Medicaid individuals to make sure that the application is being processed diligently. I will also attend both the financial and functionality reviews with my client to make sure that everything goes smoothly.

Once medicaid has been approved I normally will have the proper resources needed to either begin or continue with the the help they need. Normally I can get the providers to start before the approval if needed and at time of approval they will transition over to the medicaid program.

If you have questions or wish to start the process regarding Medicaid, I would be happy to meet with you to discuss your particular situation.