Medicaid Blog
Battle Creek - Medicaid Planning and Regulations Law Blog

After You Apply for Medicaid:

Posted December 6, 2018

Your local DHS office will decide if you are eligible for Medicaid. They will send you a letter with their decision:

  • within 45 days, or
  • within 60 days if you have a disability.

The nursing facility must be certified by Medicaid to provide the care you need. Medicaid only pays for services that are medically necessary. Medicaid only pays for nursing facility, MI Choice waiver and the Program of All Inclusive Care for the Elderly (PACE) services when you have been determined medically/functionally eligible via the Michigan Medicaid Nursing Facility Level of Care Determination.

If you are eligible, you will receive a mihealth identification card. You should also receive a notice from your caseworker advising you of the amount you are required to pay toward the cost of your care while in the nursing home. This is called a Patient-Pay Amount.

Your nursing facility will bill Medicaid for the portion of the bill you are not expected to pay. If you have applied for Medicaid, you must inform your medical provider (doctor, hospital, pharmacy, nursing facility, etc.) that you have applied for Medicaid prior to receiving medical service. You must give your medical provider a copy of your mihealth card or approval letter as soon as it is received. Your medical provider needs this information to receive prompt payment for medical services provided to you.

This information is also necessary in order to issue you a refund if you pay for the services between the date you file an administrative hearing request with DHS after they issued an incorrect Medicaid denial, and the date of an eligibility determination resulting from your hearing request.

It is the responsibility of the medical provider to submit any outstanding medical bills, using Medicaid billing procedures, to the Medicaid office within 12 months from the date of the Medicaid covered service. Exceptions to the 12-month billing policy may be authorized if the delay in billing is caused by an agency error or as the result of a decision handed down by court order or administrative hearing decision.

www.michigan.gov/nursingfacilityeligibility

 

What Assets Does DHS Count?

Posted November 2, 2018

Common liquid Assets that DHS counts when considering your application for Medicaid for Nursing Home Care (Also known as Countable Assets):

  • Cash, savings accounts and checking accounts
  • Credit union share and draft accounts
  • Certificates of deposit
  • U.S. Savings Bonds
  • Individual Retirement Accounts (IRA) and Keogh plans

Equity Assets:

  • Real estate (other than your home)
  • More than one car
  • Boats or recreational vehicles
  • Stocks, bonds and mutual funds
  • Land contracts or mortgages held on real estate sold See Appendix II for more help determining your assets.

A list of common assets DHS does not normally count are (also known as Excluded Assets):

  • Your primary residence for Medicaid eligibility, but do count the equity when determining Medicaid payment for long-term care services.
  • Personal belongings and household goods
  • One car
  • Burial spaces and certain related items for you and your immediate family.
  • Up to $1,500 designated as a burial fund for you or your spouse, if you have one.
  • Irrevocable prepaid funeral contract.
  • Value of life insurance if total face value of all policies is $1,500 or less per owner, or term insurance of any kind.

www.michigan.gov/nursingfacilityeligibility

 

To Determine if You are Eligible for Medicaid:

Posted October 22, 2018

In order to determine if you or your spouse is eligible for Medicaid to pay for nursing home care DHS will ask you to verify:

  • Income and assets
  • Age
  • Medical expenses
  • Income of other dependents at home
  • Marital status
  • Medical insurance

This is a two-step process. First DHS determines whether you are eligible on the basis of your assets. This is called asset eligibility. If you are asset-eligible, then they review your income. If you have too many assets to qualify for Medicaid benefits, your application may be denied. In order to verify assets, DHS will ask you for:

  • Proof of your income and assets. If you have a spouse, they will need proof of his or her income and assets, too.
  • If you are under age 65, they may need proof of your disability.
  • Proof that you are a U.S. citizen.
  • The documents DHS will ask for include:
  • Bankbooks or statements, including joint accounts
  • Pension payment information
  • Social Security benefit information
  • Real estate value (other than your home)
  • Recent medical bills

www.michigan.gov/nursingfacilityeligibility

 

 

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