Learn How to Avoid Medicaid Denial

Applying for Medicaid in – and then having benefits denied – can be traumatic. Many low-income Floridians depend on the healthcare assistance that Medicaid affords some of the most impoverished residents of the state. There are reasons why Medicaid applications may be denied, or why those receiving benefits may have their Medicaid benefits denied, after the fact.

One of the key reasons for Medicaid denial is simply mistakes being made on the online Medicaid application. It is easy to do, and unfortunately, accounts for many of the Medicaid denials that happen each month. The process of appealing Medicaid denial can take even longer, so taking the time to fill out the application is of crucial importance. If this is the first time filling out a form for Medicaid, applicants should consider getting help from someone when submitting the application.

Missing deadlines is another reason residents may be denied Medicaid benefits. Medicaid denial in requires that requested documentation be provided within 30 days of starting the application (not 30 days from submission). If this is the case, then reapplying for Medicaid benefits may solve the problem. However, the best strategy if a deadline has been missed is to contact the agency to find out what your next steps might be.

Many Floridians try to hide assets, and in doing so, incriminate themselves. The Department of Children and Families verifies all documented income and assets. Oftentimes, applicants who believe that they have too much income or assets will transfer these over to a family member or to a trusted friend. However, there are rules governing this type of transfer. The transfer must happen at least three to five months before applying for Medicaid, and most experts suggest making the transfer up to a year prior to applying for Medicaid benefits. The dollar amount currently is $8,346, and if a resident has that amount or more transferred to someone else, there may be penalties involved. This is especially true if the transfer happens within the 60-day window of submitting an application for Medicaid.

limits the type of assets someone applying for Medicaid may own. When initially considering income for Medicaid, many residents don’t remember to add in assets as part of the overall income. one’s home does not have to be valued as an asset, as long as the home is not valued over $250,000. However, the amounts are always subject to uctuation, so applicants should check to see what the current limits are. Planning is key when it comes to applying for Medicaid, especially if the applicant has savings, a home or retirement benefits.

Much paperwork and documentation will be required in order to apply for Medicaid, and failure to send in the financial statements, completely, is a large reason for Medicaid denial. Financial accounts have to be titled and must match the current information stored on the state database. It the name on the accounts do not match the applicant’s information on his or her application form, then the application will be rejected and the Medicaid benefits denied.

Some Medicaid denials are issued because the applicant forgot or didn’t know that he or she was required to fully disclose all forms of income. This can include loans, titles, property, annuities, life insurance policies and savings. Medicaid officers have access to most databases, and they will find and locate all of the assets during their performance of an asset search.

Many of the issues which give rise to a Medicaid denial can be because an applicant has remarried, sometimes several times. Each time, there has been a name change. This also causes a problem when there are children by different marriages as well. Couples who keep separate finances between them often are not aware of what the other person has by way of assets, but these will be counted as an applicant’s resources if the partners are legally married. All assets or policies which were held by someone whose name has changed, and who has yet to update the names on the policies, may have their application rejected.

Last, but not least, if you have been financially taken advantage of by a family member in the last few months, then it is of vital importance that a police report be filed. This is because the funds must be proven to be a gift, instead of a transfer of assets in order to qualify to apply for Medicaid. Many elderly applicants don’t want to file a police report, especially if their family members are involved; but unless there is a police report indicating that the money was stolen, leaving the applicant indigent, the applicant will not qualify for Medicaid and will be denied benefits.