A Certified Medicaid Planner Can Help You Navigate Complex Medicaid Rules
Medicaid, a federal and state program to assist the needy with healthcare, is one of the most popular government-sponsored medical insurance programs in the U.S. It provides coverage to individuals who cannot afford medical care or don’t have insurance. However, it is also one of the most complicated programs, unlike other federal programs, like SNAP. The application process is lengthy and confusing, and the rules are different in every state. Furthermore, those who exceed the income level but still need assistance must learn about the “spending down” process to qualify. For these reasons and more, it is beneficial to seek professional support in the form of a Certified Medicaid Planner (CMP).
Before we explain the purpose of a CMP, let’s discuss the difficulties of the Medicaid denial process, as applying for Medicaid has several hurdles some people can’t overcome, and denials aren’t uncommon. When people get a Medicaid denial, the process is challenging and time-consuming. Some of the challenges stem from the multiple options you have after the rejection, and you may not know which approach to take: re-apply, request a reversal, or appeal?
If you must perform the latter, you typically have 45 days to request an appeal. However, it’s crucial that you carefully read the appeal process on the denial letter, as an appeal request can be as short as 30 days or as long as 90 days.
Steps to Appealing a Denied Medicaid Claim
- Figure out the cause of your denial
- A hearing date is set by the Medicaid office when you request an appeal.
- You can perform the hearing alone, but you should hire an attorney (they understand the procedures and can strategically guide you through the hearing and guarantee a better chance of success).
The above steps are where a lot of the complexity lies. Appealing a Medicaid denial is time-consuming because it can take several months to find success, from the date you originally applied to receiving your rejection and finally having a hearing.
However, none of this is necessary when you work with a CMP from the start.
What is a Certified Medicaid Planner
A CMP is an expert in Medicaid planning for long-term care assistance. They undergo training and receive certification to qualify in this field. Furthermore, they have experience in:
- Medicaid program administration
- Care management
Additionally, they must continue to receive training every few years to stay up-to-date on the latest protocols. As a result, their expertise in the Medicaid program will help you understand the rules and guidelines of the program, even as they change.
What can they do for you?
- Structure your finances and prepare the necessary documents to get accepted into the program.
- Provide progressive financial advice, such as trust creation, asset transfer assistance, and conversion of countable assets (i.e., cash, checking/savings accounts) into exempt assets (i.e., primary residence, retirement accounts) to ensure Medicaid eligibility.
- Work to prevent Medicaid Estate Recovery – this can protect an individual’s home once they have passed away. Medicaid essentially provides a loan for long-term care. When the individual receiving Medicaid dies or is permanently institutionalized, the Medicaid program can file a lien on their house to recoup some of the costs of Medicaid services. Estate recovery can only occur if no other family member/beneficiary lives in the house.
A Medicaid planner can do a lot more, but these are some of the essential roles they assume as an advisor.
The bottom line is Medicaid planning is not for everyone. The good news is you don’t have to do it alone, so don’t be afraid to find help. It’s better to receive professional Medicaid planning and get it right the first time than get it wrong and undergo the process of re-applying, approval request, or an appeal.
Join Over 4 Million Served at Q Link Wireless
If you have successfully applied for Medicaid, you are participating in one of many government benefit programs that qualify you for the Lifeline Program or Affordable Connectivity Program (ACP). These two government benefit programs provide discounted wireless phone services for low-income individuals, including the needy, such as persons with disability, age 65 and older, children, and pregnant women.
What is Lifeline?
Lifeline is a government program that began in the 1980s during the Reagan Administration. It provides low-income individuals and households access to basic telecom services to stay connected to friends, family, work, healthcare, future job opportunities, and 911 emergency services. When partnered with a wireless service provider, like Q Link Wireless, the Lifeline Program offers discounted FREE phone services. As a Q Link Wireless customer, when you sign up for Lifeline, you receive monthly:
- FREE Data
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What is ACP?
The Affordable Connectivity Program is the latest government benefits program by the Federal Communications Commission (FCC). It also provides low-income individuals and households with discounts on monthly broadband services and connected devices. Eligibility requirements are not as strict as with Lifeline. Nonfinancial eligibility is practically the same (note: you are eligible for ACP with WIC but not Lifeline). However, you will see a difference in the financial eligibility requirements between the two programs. For example, individuals are eligible for ACP if they are at or below 200% of the federal poverty guidelines. Lifeline financial eligibility is at or below 135% of the federal poverty guidelines.
As a Q Link Wireless customer, when you sign up for the Affordable Connectivity Program, you receive monthly:
- FREE UNLIMITED Data
- FREE UNLIMITED Talk
- FREE UNLIMITED Text