by Salvatore M. Di Costanzo, Esq., and Joanna C. Feldman, Esq.
An application for Medicaid benefits to cover home care services is less complicated than an application for coverage for nursing home care, which requires submission of a full financial history for the previous five years. A Medicaid home care application requires submission of a full financial history for only the previous three months.
But from start to finish, the entire application process can take at least four to six months. In our office, the first step is a comprehensive consultation during which we review the applicant’s (and spouse’s, if there is one) income and assets. If we feel that applying for Medicaid would be beneficial from a financial perspective, we refer the applicant (or their family) to an independent case manager. After performing an assessment from a care needs perspective, the case manager will offer their objective opinion of the approximate number of hours they believe Medicaid will likely approve. This independent care assessment is important for a variety of reasons, but primarily because it manages expectations and ensures that we will not proceed with the application unless it’s worth it to the client.
For the Medicaid application itself, the client is required to gather various documentation, such as birth and marriage certificates, verification of all income, statements from all financial institutions for the last three months, and proof of certain transactions. Our office will then review these documents, request additional documents if necessary, and prepare and submit the application. The government agency then reviews the application, which often takes months. Once the application is approved, the agency will generally have two assessments performed to determine how many care hours per week is appropriate. It can often take a few weeks for these assessments to be completed. Only after this entire process is completed will Medicaid home care services begin.
Because of this timeline, it is important not to wait until the last minute or until assets are largely depleted before seeking the advice of an elder law attorney on whether a Medicaid application is appropriate.