How long does it usually take for SSA to determine Medicaid eligibility for a NH patient?

The federal statute requires the determination of eligibility be completed within 45 days, but as you can see below, the various states frequently miss this deadline.

Keep your documents handy for now.

It took Medicaid 6 months to approve my dad. He had died by the time he was approved. We were told it would take about 6 weeks.

For my mom, right under 6 mos for financial eligibility & had issues with a couple of items. Mom also had issues with medical eligibility of Medicaid as she came from IL rather than the more usual hospital discharge to a NH, so she needed to do appeal process for medical "at need". Medical appeal had that hearing set 7 mos out but the issue was resolved within 3mos of admission & before hearing ( prescriptions were left off on her initial admissions paperwork). For my mil, she died before application approved & my SIL dogged it through and mil was approved & NH paid almost a year later.

RENEWAL!! You need to put the documents in a binder to keep for future too. I don't know if all states do this but for TX Medicaid there is an annual renewal. It's a multipage form and will require some of the initially sent items (funeral/burial policy, property ownership items, life insurance, etc) PLUS the last 4 mos of bank statements and their last awards letters (the letter from SSA & retirement that states what income they will get aid for the next year). for my mom, it was around 30 pages of documents needed for the renewal plus the questionnaire. ( her initial application was about 130 pages of documents so I know your butt-rash in this.) For more fun in this, renewal due like 14 days from date of letter and it was always ALWAYS postmarked days later than the inside letter. So having stuff in a binder at the ready saves your sanity. For me what worked nicely was to put items in those clear top loading sheet protectors and then just slip each years update into it. As I said, FUN!

For my mom, the NH had a specific state caseworker who handled the financial applications for facilities in their zip code. We spoke directly as to issues with my moms financial application (?s on insurance policy and a car transfer).

My take on this is that once the NH takes the application and the documents they in turn submit it with their bill to the state and could care less from that point on if there's a glitch as they likely have you on the hook to private pay. If you signed off with your name to be financially responsible, they can go after you personally to pay. You need to do the follow up with the state on your own.

My husband died four months after he entered a nursing home under Medicaid pending. During that time neither the nursing home nor Medicaid told me had been approved for . I was worried all the time because I had been forced to sign that I would pay if Medicaid didn't approve. I knew the truth only after he died and the nursing home sent me a bill stating that Medicaid had paid. Try contacting Medicaid directly. Good luck.

I am in Tx also. I had a lady helping me and it took 5 months. Medicaid did go back 3 months and cover NH after eligibility date was established. We had not sold Moms car so we did that to pay the 2 months she was not covered and pay down some other debt. Things were moving slow so I called Medicaid and ask what do you need? Whats the hang up here? Dont think the lady that helped me appreciated it but she was the majority of the problem. This lady handled Moms first renewal. It drug on forever also. I did the second renewal. When I got the stack of documents in mail I paniced! Most of the documents did not even apply to my Mom. I called Medicaid. They told me to do it online. Oh my...it was only 10-20 pages. Submitted. Took 30-45 mins. Then caseworker told me how to submit documents thru the Medicaid App on my phone. Thru the App you screenshot the document and submit. I am not that tech savvy but caseworker talked me thru it over the phone. During the application process too many documents may be required but I took tons of documents to lady that helped with application, bank stmts, everything I thought she would need. She only needed a fraction of what I took to her. Try calling Medicaid yourself often to ask what do you need, is there a faster way to do this, can I do this online?

I did my moms Medicaid application in 2011 & before the app was available for TX. I did get the NH to sign off on receipt of initial set of required documents (which they submitted to state along with their bill) and then afterwards sent anything to TXDADS/TXHHS done either certified mail with return registered receipt if a lot of paper or if a page or two via fax with a transmission report (like sent from FedEx office store). So I positively had a documented paper trail on all. The state lost stuff a more than a couple of times in the 4 year adventure with medicaid and basically I shot over a copy of the RR card or transmission report and miraculously!! the items mia would be found.

Lizzy - does the app provide for a time date confirmation #? if not, I'd probably still opt for doing it old school snail mail. Btw any update moms house/merp/estate sale?

when working with the Elder attorney we had for my dad when applying for Medicaid, they told us it would take 6 months for the process. In the meantime, the NH could not ask for any money because they were told his was Medicaid pending. And they didn't ask for any money. Even though they sent the bill, they knew no money would be forthcoming until Medicaid was either approved or not. If you don't have an Elder attorney helping you, it would be advisable to seek one out that only deals with this stuff. Plus once approved, make sure that all doctor bills etc concerning your loved one goes back thru the system to get reimbursed (if you already paid) or to make sure that Medicaid see those bills.

I will say I love the idea of the app, although I can see this to be quite challenging to those 70++. The great thing about on-line or via smart phone is that it gets away from the subjective viewpoint of the local caseworker. I did definitely feel that if you live in a more affluent zip code (like 78209 or 75205 in TX), the caseworker - who is local - has a set bias towards what they see as a wealthier applicant so drags the application.

Had to get son to assist with APP. Followed up everything with fax. Using online application and APP it was done and verfied renewal by email in 10 days start to finish. Didnt get letter until 2 weeks later. Estate Sale was succes. SS, Medicare,Medicaid, DADS notified upon Moms death. Still nothing from MERP. Real Estate Agent getting Title company to open Title. Planning to list house Tuesday. Elder Care Attorney says if claim appears he will supply MERP with appropriate documents for release. He says all is in order...proceed.

Oh. We are a very rural Zip Code. I think our case worker was in Midland which is hours away. After initial contact with him he gave me a number that rang straight to him. Maybe because of the online,APP involvement. There was also the option to email documents and correspond but he had retired and returned and his email wasnt up.