Articles Posted in Medicaid Applications

Medicaid is one of the most utilized government programs for elderly American citizens that are in need of medical assistance that they cannot afford. In order to qualify for the Medicaid program, an applicant must meet a number of criteria and an application can either be filled out online or in paper form. However, many applicants to the Medicaid program have run into issues of red tape and other problems when attempting to apply for benefits.

Online Medicaid Application

The online application for Medicaid can be found on the federal Medicaid program website. For seniors that are tech savvy, the online application can be filled out in about 45 minutes. The website contains all kinds of information like eligibility, benefits, and required documentation needed to be considered for the program. After an online application is submitted, there may be follow-up phone calls by the program to make sure that everything regarding their application is in order, but usually an accepted applicant can receive their benefits card within 45 days of submitting the online application.

The first part of this article explained that there are many programs and benefits available to seniors that live in New York. The second part of the article continues to explain various services that are available to the state’s elderly population.

Temporary Assistance

This program provides cash benefits for senior citizens with limited income for essential food, clothing, and shelter items. You can be any age to apply, but people over the age of sixty do not have to meet the program’s work requirements. The resource limit for an individual is $2,000 and $3,000 if any household member is ages sixty or older. Employed applicants may be able to disregard some of their earnings and still qualify for the program. There is a sixty month limit on this program, and it applies for the lifetime of the applicant.

Elderly couples are divorcing at a higher rate than ever before for a surprising reason: soaring medical and long-term care costs. These expenses are being aggravated by longevity and uninsured risk from a lack of long-term care insurance. Although these senior couples still care for each other very much, the cost savings from divorce are inflicting the least amount of damage when compared to other financial options.

Medicare and Medicaid

Seniors are now turning to divorce to stave off financial ruin trying to qualify for Medicare and Medicaid coverage. In terms of Medicare coverage, the program only covers 100 days of nursing care. If you or your spouse needs long-term nursing care you must either pay out of pocket until your assets fall beneath a certain threshold or tap into your long-term care insurance if you have it.

When Medicare was expanded in 2003, the expansion that established prescription drug coverage was called a “promise, a solemn promise, to America’s seniors.” Part D Medicare officially took effect in 2006, but still some seniors were afraid of falling into the infamous “doughnut-hole” coverage gap.

Initial Benefits of Part D

In Part D’s first few years, national data has shown that the program had helped seniors make progress with their prescription drugs. Overall, out of pocket costs decreased for medication, seniors took their medication more regularly, and were less likely to forego basics like food or heat in order to afford for their prescriptions.

Uncertainty reigned over the last few months regarding the budget situation for the New York Medicaid system. Fortunately, an agreement has been reached which should provide more long-term stability and the ease the minds of both policymakers and NY residents alike.

The underlying problem was claims by the federal government that over a period of years New York engaged in improper billing practices. The mistakes led to billions of dollars being paid to the state that should not have been paid. After discovering the problem, federal officials initially claimed that the money needed to be re-paid. All told, this would amount to nearly $15 billion being drained from state coffers that otherwise would provide support to local residents. No matter which way you slice it, losing those funds would hurt New York Medicaid participants, including seniors.

Settlement Agreement

As the first wave of healthcare insurance enrollment ends as part of the Affordable Care Act, observers are quick to comment on the changes enacted by the law. In addition to millions who took advantage of insurance sold in private marketplace exchanges, there has also been a significant increase in Medicaid participants–both in New York and nationwide.

According to a New York Times report last week, across the country there are now over 62 million Americans receiving some Medicaid support. The increase is more targeted in states like New York that specifically took advantage of options in the Affordable Care Act that allow for expansion of the program.

Importantly, much of the discussion about healthcare exchanges and Medicaid expansion refer to general health insurance coverage–not necessarily care that includes long-term support for the elderly.

The face of New York nursing home care has been changing in recent years. The traditional model of individual counties throughout the state owning and operating facilities to provide care to ailing seniors is being phased out in may places. Instead, the counties are selling the homes to private companies to operate. The moves are spurred in almost all cases by financial realities–the facilities are too expensive for the county to operate.

Understandably, elder advocates worry about the effect of the change on senior care. In the past, some analyses have suggested that privately-run nursing homes, on average, show more “deficiencies” than their public counterparts. The assumption is that private homes are motivated by profit and more willing to cut resources to residents and refuse to pay wages for the best caregivers in order to boost their bottom line.

But is is important to remember that no two homes are identical, and “averages” do not mean that all privately run homes are rampant with neglect and need to be avoided. Early reports out of Ulster County, for example, offer a hopeful reminder that quality decreases may not automatically follow private nursing homes sales.

New York State has the largest Medicaid system in the country. As most know, Medicaid is a joint state-federal program that provides healthcare to low-income residents. Unlike Medicare (which is a program exclusively for seniors based on their age), Medicaid is for all those who do not have enough assets to pay for the insurance they need out-of-pocket.

Medicaid provides general health care to residents of all ages. In addition it acts as the primary public provider of support for seniors in need of a nursing home stays or other elder care. Considering that each kind of support comes from the same pool of Medicaid money, it is useful for those reliant on the Medicaid system to keep up with all matters that affect the overall budget. In other words, any NY Medicaid budget issues may eventually affect elder care and support options.

Federal Government Adjustment

The New York Medicaid system is the primary source of funding for many seniors in need of long-term care at nursing homes. Medicare does not cover these extensive stays, and the out-of-pocket costs are tremendous. As a result, many seniors enroll in the program to pay for their care.

Payments for long-term care make up a sizeable part of the entire Medicaid budget. As a result, policymakers are often looking at ways of cutting expenses or funnelling more money into the program to pay for those in need. One way that Medicaid law has accounted for ths is via a Medicaid estate recovery program. The basic idea is that the state can re-coup portions of the funds spent on an individual under Medicaid after that person’s passing. This takes the form of the state receiving a portion of the decedent’s assets.

The laws regarding Medicaid estate recovery are quite complex, with exceptions depending on surviving spouses, dependent children and similar details. But, under current rules,recovery may be made on “assets passing under the terms of a valid will or by intestacy, and any other real and personal property and other assets in which the decedent had any legal title or interest at the time of death…”

If a New York senior is in immediate need of close, skilled, long-term care and lacks the resources to pay the (quite high) fees for such care are out of pocket, then the only recourse is usually the New York Medicaid system.

But far too many residents fail to appreciate the basic details of this system until they are confronted with the reality head-on. Most notably, Medicaid, unlike Medicare, is based on need–not age. Therefore, the only way to qualify is to have a set asset level that falls below a certain threshold. Many families who have spent a lifetime saving and investing in their home have assets above that threshold. Therefore they are forced to spend down their resources in order to qualify for needed Medicaid support.

A New York Times story from last month discussed how many elderly couples in the past were essentially forced into poverty in order to receive Medicaid help. One story from the 1980s is shared involving a couple who were married for 45 years before divorcing in the mid-1980s. The divorce was not pursued because the couple had fallen out of love, but because it was the only way to avoid the healthier partner from being forced into poverty to ensure the couple qualified for Medicaid.

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