When a person achieves successful enrollment in any Medicaid program, be if for healthcare, health insurance, long term care, mental health assistance, or any healthcare coverage, periodically the Medicaid recipient will be subject to a periodic audit to ensure that their Medicaid coverage and eligibility is still appropriate, both from a financial need perspective and from a physical need point of view. Unlike Social Security, Medicare, other gov health plans and some other federal government programs, Medicaid coverage does require periodic Medicaid renewal.
In Missouri, for long-term care Medicaid eligibility, the state Medicaid office requires renewal on an annual basis, typically the renewal date is the anniversary month of the month of original eligibility. Your local department of social services or human services will send a renewal packet and renewal form to the recipient at the address of the long-term care facility, or to the mailing address of the individual or the family member who is the recipient’s responsible party, if the state Medicaid office possesses that contact information. This annual renewal process principally covers the financials side of the equation, ensuring that the recipient does hold too much in the way of assets and thus has been disqualified for Medicaid at some point after the initial Medicaid application.
The renewal form principally requires the applicant, or family member, to provide financial account levels, and often bank statements, to establish continued financial eligibility. Additionally, the renewal form will require an update on Social Security payments and pension amounts. Any adjustment in these monthly payments can affect the monthly co-pay under the health plan to the long-term care facility. It is not necessary to meet with the state Medicaid office in person; the forms are sent typically through the mail, if all necessary phone numbers are available, any follow up can be taken care of remotely.
Additionally, the state can also require an assessment of the individual to determine if the Medicaid recipient still requires care or the health benefits provided. The healthcare provider typically takes care of most of this part of the process. If the nursing home resident’s health situation has not changed dramatically, there is very little to fear from this assessment.
Finally, the state website contains a great deal of very user-friendly information if the recipient or the family members are confused. The website contains a great set of forms and faqs to help families. A helpline is even available.