Top 8 Reasons Medicaid Applications Are Denied or Delayed

Hill & Kinsella

Why Was My Medicaid Denied?

Understanding why your Medicaid application was denied is crucial to rectifying the situation. Primary reasons include incomplete applications, failure to respond swiftly to Medicaid correspondence, being over income limits, and more. Learn more in this blog by HKH Elder Law -- receiving professional guidance can significantly increase your chances of approval.

Our lawyers proudly use our legal skills to help clients make arrangements for the long-term care services they may need in the future. One of the ways people commonly pay for long-term care is through Medicaid. But qualifying for Medicaid can be more challenging than most people realize. Keep reading to learn about the top eight reasons Medicaid applications are denied or delayed.

Reason #1: Incomplete Applications or Documents

Now it is more important than ever to have a complete packet when filing your Medicaid application. In the past, they would wait for supplemental documents as long as they knew you were trying to get the additional information. However, if you fail to complete the application or don’t provide the right documents, they are now quick to deny it if you don’t follow-up.

Reason #2: Failing to Respond in a Timely Manner

Once the application is filed, if Medicaid has questions, they will send a letter requiring a response within 10 days. That’s 10 days from when they send it, not when you receive the letter. Some will allow an extension, but gone are the days when applicants could extend their case several times. We find it best to collect as much as possible BEFORE filing the application.

Reason #3: Income Too High

Since Florida is an “Income Cap State,” there is no flexibility when it comes to being over the income limit. All income, no matter where it is from, counts.

Reason #4: Filing to Early

If you are not financially eligible for Medicaid when you file, your application will be denied. Also, if you do not need the care yet, you will be denied.

Reason #5: Filing Too Late

Medicaid will go back up to 90 days, only as long as the applicant was eligible during that period, but not any longer.

Reason #6: Too Much Money

Medicaid has strict limits on how much an individual, and if applicable, their spouse can have. Being even slightly over can cause one to be denied. However, with proper and careful planning, certain assets can be protected.

Reason #7: Income Trust Isn’t Properly Funded

An income trust is the only solution for being “over income”. Having the trust is only step one. An account for the income trust must be established and every penny that is over the income cap limit must go through this trust. If not, the applicant will be denied for that month.

Reason #8: Physician’s Statement

If not completed properly, and signed & dated by the physician, the Medicaid application can be denied. Filers should stop and fully review before sending in forms completed by others.

Am I Eligible for Medicaid?

Are you having trouble making sense of Medicaid terminology? Do you need guidance as you fill out your application? Then please call our law firm today so we can discuss your situation and devise a strategy to help you qualify for Medicaid benefits. Federal Medicaid laws are complicated, but with counsel from our seasoned lawyers, you can feel confident knowing your best interests are protected each step of the way.

By, Jonathan Kinsella

To schedule a consultation with a lawyer at our firm, give us a call at (727) 240-2350.

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