Medicaid Pending - THE GRAND

Medicaid Pending

Medicaid Pending

Jessica Leffler
Business Office Coordinator
The GRAND of Dublin

MedicaidAs the Business Office Coordinator, working with all types of insurances is a daily occurrence within the facility. Medicaid Pending is different from typical insurance as BOC’s work with the family to gather information to submit to Job and Family Services (JFS) so the resident is able to get Medicaid. Some common things that JFS require when applying for Medicaid first is to fill out the application, which includes income information such as all bank account balances, life insurance policies (cash value amount is required) , social security, retirement accounts, pensions, annuities, etc. Also, if there is any properties such as cars or houses in the residents name, or if there is a spouse in the community. Other documents that are required is proof of citizenship which includes social security cards, birth certificates and drivers licenses.

If a resident owns a house, they are able to keep possession as long as they plan on returning to their house at some point and they submit that in writing to JFS. If there is a spouse in the community, JFS allows the spouse to keep the house and cars, and does not include their income in the residents break down of financials and assets. Medicaid has recently changed to this in the past few years, as many are still nervous that they will lose their homes and all the income just to receive Medicaid.

All assets combined need to be under $2000 to qualify for Medicaid. If they have more than the required limit, they are able to spend down the funds, which would include paying the residents bill privately at the facility and purchasing any items that the resident would need. One applying for Medicaid often has a misconception that they are able to gift property or funds that they have to a family member so they do not lose the items, but this can disqualify them from receiving Medicaid and delay the process for up to five years due to a penalization.

As the Business Office Coordinator, I am there to help any residents and family members with any questions/concerns that they may have with Medicaid or any other insurances. It can be an intimidating process and lengthy, so it is my job to make it easier for them as they are already dealing with transitioning into long-term care, or working on getting themselves stronger to go home.

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