The process of addressing long-term care for a family member or a loved one can be daunting, particularly when exhaustion of the care recipient’s assets is a possibility. Health care coverage (including supplemental plans) and Medicare rarely pay for long-term care, leaving a family to contemplate spending all of the family member’s assets and/or attempting to qualify for Medicaid assistance. It takes smart family planning to ensure the process goes smoothly. But not to worry. Excellent care is available for any family that takes the proper planning steps, even if the person in need is low income and/or has low assets.
However, this situation leaves the family with the following challenges: how do we find an excellent nursing home that can provide excellent care and can also accommodate the resident’s need to use government assistance (i.e. Medicaid) to pay for care. Some nursing homes do not accept residents (and in fact are not allowed) that require Medicaid benefits to pay for their care.
Once care has been found, and Medicaid is required to pay for care, the focus then shifts to applying for and receiving eligibility for Medicaid benefits. Many attempt to apply for Medicaid themselves, often with middling results. The failure to obtain Medicaid eligibility on the first attempt often results payments due to the nursing home until eligibility is obtained.
At QMC, we specialize in Medicaid eligibility for long-term care assistance. Our professionals have filed thousands of applications, divisions of assets, renewals, claims, and appeals for long-term care enrollment, health care, medical assistance, etc. Additionally, we have worked with over 100 nursing homes in our 25 years of experience. And we have developed long-term, lasting relationships with the caseworkers and officers in the service centers of the Missouri Department of Human Services, Department of Social Services, and other Medicaid programs. Trust us, we know the State phone number very well. And, if possible, we attempt to meet the Medicaid program caseworkers in person.
If you have a loved one that requires eligibility in the Medicaid long-term care assistance program, and turn to QMC to ensure a smooth path to eligibility, our office will handle all of the Medicaid application steps, and our office will file the Medicaid application for you. You never have to meet any Department of Social Services Medicaid caseworkers, or make any trips to the state offices. You only need to work with us in our office. (We can provide services remotely through Zoom and telephone conferences, if necessary, but we prefer (at least once) to meet our clients in person.) This meeting will also allow us to determine if there may be other Medical Assistance and Medicaid coverage to which the applicant may be eligible. For example, an additional pension is available for any applicants who may be blind.
When you let QMC take care of your Medicaid application process, you can expect the following:
- In our initial meeting, we will fully assess your or your loved one’s long-term care and medical assistance needs. Once we have determined that a clear path to Medicaid eligibility exists, you will be assigned a caseworker who will walk you through the entire Medicaid application . We will gather the basic information we need to open our file, including the loved one’s current status, current health care needs, current care providers, contact information, etc.). We, of course, are available to answer any questions you may have. (We have a written FAQ sheet for you that answers many Frequently Asked Questions.) We will provide you with a packet of the information and documents you will need to bring to your next meeting, the Documentation Meeting.
- We will also contact the nursing home or current care provider to touch base and to ensure that all parties are on the same page.
- If necessary, we will provide with a list of appropriate nursing homes, and other care facilities that would be appropriate for the loved one. We hope that you would visit some or all of the suggested facilities to determine the best fit for the resident.
- Within 10 days of your initial meeting, we will meet again for our Documentation Meeting. At this meeting, your caseworker will collect and review the documentation you have gathered (documents that cover power of attorney, health insurance, supplemental health insurance programs, current care services, health services, Medicare.gov card, birth certificate (indicating date of birth) phone numbers, social security number and card, medical bills, home deed, bank statements, etc. This will give our firm the information we need to compile our Medicaid application and supplemental packet to be delivered to the Department of Social Services.
- Once the application and supplemental documentation has been prepared, our office will submit the application to the Department of Human Services (DHS) service center (typically by post, DHS prefers paper applications). We will meet with the Department if any additional documentation is necessary. We will provide a waiver that will direct the Department of Human Services to contact our office directly. We will work with DHS and with you to gather what is needed and provide a fast turnaround.
- Our office has never failed to reach Medicaid eligibility in any case in which the family was able to fully provide all required documentation.