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How to Apply for Medicaid in 3 Steps
- You can apply for Medicaid even if you’re not sure you qualify
- The Medicaid application process
- Renewing your Medicaid application
Medicaid is a state-administered program for low-income and disabled U.S. citizens and legal aliens. Although many of the coverage details are determined by individual states, each state must provide certain services, such as specific hospital and doctor services.
It’s possible to be eligible for both Medicare and Medicaid. If you think you might qualify, you need to fill out a Medicaid application. If you do qualify, Medicaid can help pay for your Medicare premiums, deductibles, and/or coinsurance.
You can apply for Medicaid even if you’re not sure you qualify
The Centers for Medicare & Medicaid Services (CMS) advises you to complete a Medicaid application even if you’re not sure you qualify. Remember that it’s better for you to apply for Medicaid and be turned down than not to apply at all. A caseworker will review your case to determine whether or not you qualify for Medicaid benefits. Your Medicaid eligibility can change from year to year, so you may want to complete a new Medicaid application each year, even if your application was previously turned down.
The Medicaid application process
Step 1: See if you’re eligible for Medicaid in your state.
Here are two ways you can learn more:
- Visit the healthcare.gov website.
- Call your state Medicaid office.
Medicaid programs and application processes differ from state to state. Visit the CMS.gov page to learn about Medicaid program details and the specific Medicaid application process in your state.
Step 2: Gather all necessary information to fill out the Medicaid application.
Medicaid applications are often denied because of incomplete information on the application form. Before you submit your Medicaid application, be sure to have all of the following documentation ready.
- Proof of age (birth certificate or driver’s license).
- Proof of citizenship or alien status.
- Proof of all sources of income (paystubs or tax return, Social Security, Supplemental Security Income, Veteran’s benefits, retirement accounts, and any other income).
- Proof of assets and other resources: include copies of bank statements or other financial resources if directed on your Medicaid application.
- Proof of your disability: if you think you qualify because you’re disabled, you’ll need to include documentation as specified in your Medicaid application.
- Proof of residence (rent receipts or landlord statements, a copy of your mortgage, recent mail addressed to you at your current address): make copies to include with your application.
- Proof of other insurance: include a copy of your red, white, and blue Medicare card (or other insurance ID card) with your Medicaid application. Remember that state applications and instructions may vary. Check your state’s Medicaid application website to see if they ask for additional documentation.
Step 3: Submit your Medicaid application.
Follow your state’s instructions for submitting your application. Medicaid application options may include paper applications, online application submissions, and even in-person applications at your local Medicaid office.
States must respond to regular Medicaid applications in 45 days (up to 90 days for disability applications).
If your Medicaid application isn’t approved, you have the right to appeal. If your Medicaid application was turned down for missing information or documentation, get whatever is needed and follow the instructions on the denial letter to resubmit the application. If you feel the denial of your application is incorrect, provide documentation to prove otherwise. Your rights for appeal will be outlined on your Medicaid application denial letter.
Renewing your Medicaid application
You must fill out a new Medicaid application every year to stay in the Medicaid program. The Medicaid application process may be easier each year. For example, if they already have your birth certificate on file, they may not ask for it again with your next application. However, information such as your income or alien status may change from year to year, so you’ll be asked to provide an update every time you renew your Medicaid application.
Medicare information is everywhere. What is hard is knowing which information to trust. Because Medicareprofessionaladvisors are following the CMS regulations, you can rest assured you’re getting accurate information so you can make the right decisions for your coverage.
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Medicare Part A
Part A of Medicare covers hospitalisation. Inpatient treatment, limited time in a licenced nursing facility, limited home health care services, and hospital care are all covered under Part A.
Medicare Part B
Non-hospital medical costs such as doctor's appointments, blood tests, x-rays, diabetes testing and supplies, and outpatient hospital treatment are covered by Part B benefits. For this component of the original health insurance, you pay a monthly fee.
Medicare Part C
In a health insurance plan, Medicare Advantage or Medicare Part C normally covers all forms of health insurance coverage. Private insurance businesses that have been contracted by the CMS to provide a medicare plan as an alternative to the original health insurance plan provide it.
Medicare Part D
Medicare Part D is a prescription medication coverage option. Part D health insurance is available as a stand-alone plan from private insurance firms, with monthly rates varying from one to the next. Depending on the plan you're registered in, you'll split the cost of your prescription medicines.
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You get the same coverage as Original Medicare plus additional benefits from the Medicare Advantage insurance provider when you enroll in a Medicare Advantage plan.
There are many of savings to be had, but here are a handful you might not be taking advantage of right now:
- Your Social Security benefit will be reduced by $144 each month.
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- Initial Enrollment Period – Most persons can enrol in Medicare Part A, Part B, Part C, and/or Part D for the first time within a seven-month period: three months before, three months during, and three months after they reach 65.
- Special Enrollment Period (SEP) – Certain life circumstances, including as moving or losing current coverage, may qualify you for coverage. You usually have two months to enrol, depending on your circumstances.
- Medicare Part C & D Annual Enrollment Period (AEP) – Every year, from October 15 to December 7, Existing Medicare beneficiaries can take advantage of this time to review and adjust their Medicare Advantage (Part C) and Medicare prescription medication plans (Part D). You cannot utilise AEP to enrol for the first time in Part A and/or Part B. The following year’s coverage begins on January 1st.
- Medicare General Enrollment Period – Every year, from January 1 to March 31, While the majority of individuals will receive Part B coverage when they join in Medicare, this period is allocated for those who did not enrol in Part B when they initially became eligible. Coverage begins on July 1st of the following year.
- Medicare Advantage Open Enrollment Period (OEP) – Every year, from January 1 to March 31, You can change to a different Medicare Advantage plan with or without medication coverage during this period, or move to Original Medicare and join a separate Medicare Prescription Drug plan. You cannot, however, go from Original Medicare to a Medicare Advantage plan, join a prescription drug plan while on Original Medicare, or change from one prescription drug plan to another prescription drug plan while on Original Medicare.