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Medicaid
What Your Client Needs to Apply
Your client may need, at a minimum, to provide the following
information to apply to Medicaid:
- Social Security number
- Proof of disability from a qualified physician
- Information about income and assets (anything that can be
used to buy food)
 Application
Process
Renewal
Process
Appeals
Process
Application
Process
Once your client applies for Medicaid benefits,
his/her application should be processed within
45 days from the date the application was submitted
if he/she has provided all the necessary information.
If your client has a disability, the application
process can take up to 90 days.
If your client applies for Medicaid
through a joint program application (i.e., Medicaid, Food Stamps or TANF
application), your state must still determine
Medicaid eligibility within the Medicaid time standard (45 days and 90 days
if your client has a disability).
If the application process is delayed due
to a non-Medicaid related requirement, the Medicaid portion of the
application must still be processed in order
for a determination to be made in a timely manner consistent with Medicaid
rules.
For more information on Medicaid in your state, visit www.cms.hhs.gov/medicaid/statemap.asp.
Renewal
Process
Once your client is determined eligible for Medicaid,
the state must review his/her eligibility at least
once a year or when there is a change in his/her
circumstances, such as an increase or decrease
in any cash assistance he/she might be receiving.
Determinations of blindness and disability are
not subject to annual redetermination.
During the renewal process, the
state is required to conduct an ex parte review.
This means that states are required to rely on
information that is available to state Medicaid
agencies, without contacting the client, in order
to determine if the client remains eligible.
Your client should not be required to provide information
that:
- Is not relevant to his/her
ongoing eligibility
- Has already
been provided or relates to an eligibility factor that is not subject
to change, such as date of birth or U.S. citizenship
Appeals
Process
If your client is denied enrollment into Medicaid, he/she will receive
a notice from the state informing him/her of the denial, reason(s)
for it and the appeals process. If your client wishes to file an appeal,
it should be done as soon as possible to avoid Medicaid benefits being
cut off.
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