Medical Assistance Nursing Home Care
The Medicaid Nursing Home Care, previously “Chronic Care Unit,” processes Medicaid applications for those individuals who are seeking help in paying for nursing home or long term home health care services.
Who is Eligible?
Financial eligibility is determined based on the income and resource standards governing the Medicaid Program. A Supplemental Security Income recipient is granted Medicaid based upon his/her certification for SSI Benefits.
Benefit Levels
The amount of assistance that the Medicaid program will pay toward the cost of nursing home and/or home care services is determined using a comparison of the available income and resources of the applicant against the cost of the medical services needed. Since each financial and medical circumstance is unique, the regulations and policies governing what assets are exempt and what assets are used in the determination of eligibility vary, therefore, income and resource standards are not listed here. Anyone who needs financial assistance in paying for nursing home or long term home health care services is encouraged to contact our office for consultation regarding their specific need for benefits.
What to Expect
WHAT DOCUMENTS WILL YOU BE ASKED TO PROVIDE?
The law requires that you provide documentation to verify your sources of income, your assets, birth date, marital status, and citizenship, as well as some other items. Below is a list of some of the items that will be required.
- Birth certificates for the applicant and spouse
- Social security cards for the applicant and spouse
- Alien registration card / I-94 card / Naturalization papers for the applicant and spouse
- Marriage certificate or separation papers or divorce papers
- Death certificate(s) of spouse(s)
- Veteran Discharge papers for applicant and /or spouse
- Power of Attorney Papers
- Written Authorization to Represent the Applicant
- Medicare and other health insurance cards and verification of monthly premiums
- Verification of ALL sources of income for the applicant and the spouse, such as but not limited
to: wages, social security, pensions, veterans and military benefits, interest and dividend
income. The gross amounts must be verified, with all deductions, and the frequency with
which the income is received. - Verification of ALL the assets of both the applicant and spouse MUST be documented. Examples of some types of assets that must be documented are (but not limited to): checking & savings accounts,CD’s, stocks, bonds, mutual funds, retirement funds, annuities, Life insurance policies, burial spaces, burial funds, all properties owned, vehicles, mobile homes and RV’s.
If you are seeking nursing home services, monthly statements for all financial accounts for the 60 months prior to the date of application must be provided. This includes accounts currently closed but that were active at any time in the 60 month look back period. If the applicant or spouse set up a trust or are the beneficiaries of a trust, the trust document must be provided and all assets owned by the trust must be documented for the 60 months prior to the date of application.
Once an application is received and reviewed if any further documentation is required a pending letter will be issued. This letter will include the name and phone number of the individual processing the application as well as a due date for submission of the information.
RENEWAL OF ELIGIBILITY & REPORTING RESPONSIBILITY
If you are found eligible for ongoing Medicaid benefits you will be required to re-establish your eligibility at regular intervals as determined by the New York State Social Welfare law. This is called recertification or renewal. You will receive notification of your recertification/renewal by mail. The completed form must be returned by the due date listed in the notice for your benefits to continue.
If you have any questions, you may contact the Medicaid Nursing Home Unit at 315-435-2928.