Medicaid is a federal program designed to assist low-income individuals with medical care and long-term care needs. The application process is complex and time-consuming. You must show you qualify based on strict income and asset ownership eligibility requirements.
Once you submit your application, you may find that it gets denied. Some of the common reasons to deny a Medicaid application include:
- Failing the 5 Year Look-Back Restriction. If you transferred assets out of your name and into someone else’s within five years of the date of your application, you may be subject to a penalty period before you can become eligible for benefits. Medicaid will “look-back” at assets owned for the five years preceding your application.
- Excess Assets. To qualify for Medicaid, an applicant cannot own more than $2000 in assets. There are exceptions that your elder law attorney can discuss with you.
- Incomplete Application. Your application must be thoroughly completed and all required documentation provided. You may be required to provide copies of bank records, property deeds and insurance records.
If your application is denied, you will receive notice within 45 days of your application submission. The notice will explain the reasons behind the denial. Review it carefully and seek the assistance of an elder law attorney if you do not understand why the denial occurred. An elder law attorney can also determine whether you have grounds to file an appeal.
The appeal must be timely filed prior to the stated deadline given on the notice of denial. Appeals are then assigned a hearing date. You must attend the hearing, state your case and present witnesses. The federal attorneys will question your witnesses and review the evidence you present. You may also review the evidence they present and question their witnesses. It is often in your best interest to hire an attorney to conduct the appeal on your behalf. You still need attend the hearing, but you can leave the legal matters to the experts.
If you win the appeal, your benefits will be retroactive to the date of your eligibility- which is typically the date of your application. If you lose the appeal, there are still additional legal steps that can be taken by a disability attorney.
If your application was denied based on having excess income and/or assets, there are strategies that can be taken to allow for a future application. Ideally, you should visit an estate planning attorney to discuss these strategies long before you need to apply for Medicaid. For assistance in long-term care planning contact the experienced attorneys at Stouffer Legal in the Greater Baltimore area. You can schedule an appointment by calling us at (443) 470-3599 or emailing us at office@stoufferlegal.com.
