An Introduction to Medicaid Here is some information on eligibility and the application process that will help you access Medicaid benefits for your clients who are homeless.

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Determine Your Client's Status
Medicaid is available to individuals and families who can demonstrate need as established through income and asset standards. Your client must also be a child, have dependent children, be pregnant, blind, disabled, or age 65 or older. Determine if your client falls into one of these categories.

Find Out If Your Client Has Already Applied for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)
Recognize that your client may need to establish disability to qualify for Medicaid. Find out if your client has already applied for benefits for SSI or SSDI. If no medical record is available, begin the process of establishing one. Submit an application for Medicaid as soon as possible, even if your client does not have complete documentation. In many cases, the date you submit the application is the date benefits begin, even if it takes a while to complete the application.

Medicaid May Pay for Some Medicare Costs
If your client is a low-income elderly or disabled Medicare beneficiary, the Medicaid program may pay Medicare premiums. In some cases, Medicaid may even pay the Medicare co-payments and deductibles.

Clients with Tuberculosis or Breast or Cervical Cancer May Be Eligible for Medicaid Benefits
Keep in mind, states may offer Medicaid benefits if your client falls into one of the following categories:

• Tuberculosis (TB)-infected clients who would be financially eligible for Medicaid at the Supplemental Security Income (SSI) level (only for TB-related ambulatory services and TB drugs/antibiotics)
• Low-income, uninsured women screened and diagnosed through the National Breast and Cervical Cancer Early Detection Program of the Centers’ for Disease Control and Prevention and determined to be in need of treatment for breast or cervical cancer. For more information, visit www.cms.hhs.gov/bccpt.

Recognize That Your Local Medicaid Program May Have a Different Name
Medicaid is a program that is run jointly by the states and Federal government and varies from state to state. This is important to remember because your local program may be called something other than Medicaid. For example, in California the Medicaid program is referred to as “MediCal,” in Northern Virginia it is referred to as “Unicare,” and in Georgia it is referred to as “Georgia Better.” To find out what the Medicaid program is called in your state, visit www.herc.research.med.va.gov/FAQ_I14.htm.

Contact Your State Health Insurance Assistance Program For Help
There is a State Health Insurance Assistance Program (SHIP) in your state with volunteers who are available to discuss your client's situation and provide information on available options. For more information about the SHIP in your state, visit www.medicare.gov/contacts/related/ships.asp.

Apply Through Your State or Local Office
Your state or local office will be responsible for the processing of Medicaid applications - they are the contact for getting applications and answering your questions. Some states allow individuals to apply on the Internet, by telephone, or at locations in the community, such as health centers.

Expedite the Process By Being Your Client's Authorized Representative
Being your client’s authorized representative may ensure that the application or renewal does not get stalled in the event your client may not receive or respond to the mail. If your program permits you to act as a representative, ask your client to authorize you to be his/her representative. You may need to have your client sign a form in order to make the transaction legal.

Processing a Medicaid Application Takes Time
The state must process a complete regular Medicaid application within 45 days. However, the state has 90 days to process a complete application based on disability. Many unsuccessful applications are denied due to lack of documentation or incompleteness.

Check Out Experimental, Pilot or Demonstration Projects in Your State
Some states operate experimental, pilot, or demonstration projects (sometimes called waivers) that allow for the expansion of eligibility for those who would otherwise not be eligible for the Medicaid program and/or for the provision of services that are not otherwise covered by Medicaid. For more information on what may be available in your state, visit www.cms.hhs.gov/medicaid/waivers/waivermap.asp.

Once Your Client Acquires Medicaid Eligibility, Help Him/Her Keep It
Keep a record of when your client became eligible for Medicaid. Prior to the time when your client’s eligibility is ending, you should assist him/her with the renewal process.

Your Client Can Appeal Any Medicaid Decision
Your client can appeal any Medicaid decision, particularly those related to eligibility. Your client may even file an appeal if there is a delay in making an eligibility determination. There will be information on how to appeal printed on the decision notice your client receives in the mail.

Some Hospitals Provide Care While A Medicaid Application Is Pending
Some hospitals will provide “free” medical care to your clients even if his/her application is pending.

Look into Medicaid HMOs In Your State
Check with the local Medicaid office about Medicaid Health Maintenance Organizations (HMOs) in your state. If your client is eligible for Medicaid, he/she may be able to enroll in a Medicaid HMO and may, thus, have access to expanded benefits.

> More information on Medicaid:

Benefits Your Client May Receive
What Makes Your Client Eligible
What Your Client Needs to Apply
If Your Client is an Immigrant
Contact Information
Medicaid Program Q & A
Medicaid Fact Sheet