When you apply for Medicaid coverage, a caseworker with review and assess whether you qualify for Medicaid benefits. Eligibility is need-based determinative, so it is important that you have evidence of your qualifications for the program. Make sure that before you apply, you have the necessary documents in hand.
The first step in applying for Medicaid coverage is to get an application form. You may apply online, by mail, or in person at your local Medicaid office. You obtain an application by going to healthcare.gov or by calling your state Medicaid office. If you choose to get the application online, go to healthcare.gov and then scroll to the bottom of the page. At the bottom of the page, you will be able to select your state. It is important to select the state you live in, as every state’s Medicaid benefits and applications vary.
The second step is to gather all necessary information in order to fill out the application. According to Medicaid.gov, the most common reason for an application to be denied is due to incomplete information provided on the form. Make sure that any space on the form is completely filled out. If you are not sure how to answer a question on the form, call Medicaid at 1-800-505-5678 or consult with a qualified Medicaid application professional.
In addition to completely and honestly filling out the application form, you will need to provide documentation. The necessary documents include:
- Proof of age (birth certificate, driver’s license or U.S. passport)
- Proof of citizenship or alien status (U.S. passport, birth certificate, naturalization papers, alien registration card)
- Marital status (marriage certificate, separation papers, divorce papers, spouse’s death certificate)
- Proof of income (paystubs, tax returns, Social Security, Supplemental Security Income, Veteran’s benefits, retirement accounts, and any additional sources of income)
- Proof of assets and other resources (copies of bank statements or other financial resources)
- Proof of disability
- Proof of residence (rent receipts, landlord statements, copy of mortgage, recent mail addressed to you at your current address)
- Proof of other insurance (Medicare cards, insurance ID card)
If one spouse plans on remaining at their current or another residence, often referred to as in the community, but the other will be placed in a nursing facility, make sure to additionally provide:
- Spouse’s ID and cards
- Utility bills
- Real estate taxes
- Mortgage statements, rent receipts
- Home or Renter’s insurance
Finally, you submit the application and wait. Medicaid applications will be responded to within 45 days, up to 90 if a disability is being claimed. If your Medicaid application was denied, you may have the right to appeal the decision. The denial letter will provide full information on why your application was denied and what rights you have to appeal. Make sure that you can support the reason why your denial was incorrect by providing additional documents to show otherwise. Moreover, if your application was denied because you had missing or improper documentation, gather what is needed and resubmit the application.
Do I Need to Re-Apply Each Year?
In order to stay in the Medicaid program, you will need to submit a new application every year, but the process may get easier as you go along. If you have already provided Medicaid with documentation of your birth certificate and proof of citizenship, it is likely that you will not have to provide those documents again. However, proof of income, assets, disability, and residence may change year to year. For this reason, you will need to provide an update on those documents each year.
I’m Not Sure If I’m Eligible?
If you are an applicant that is unsure whether you will be eligible for Medicaid, submit an application anyways. Applying and being turned down for Medicaid will have no effect on your application if you apply later. It is better to apply and get turned down than to not apply when you may have been accepted. Your Medicaid eligibility could change year to year. Therefore, if you truly need Medicaid to assist with health insurance coverage, make sure that you re-apply each year.
For those seeking assistance with Medicaid applications, P&P Medicaid can handle the entire application and document acquiring process and appear on the applicant’s behalf for all interviews with Medicaid. For more information about the Medicaid application process or any of our other services or to schedule a consultation, contact our Long Island Medicaid application professionals at (516) 541-4770 or fill out our contact form.