MEDICAID: A BASIC OVERVIEW For New York State applicants and recipients Sponsored by Elderplanning November 2001:  "Qualifying for Medicaid" Click here to return to the Elderplanning Home Page Medicaid is an entitlement program sponsored by the State and Federal government. Medicaid provides financial assistance to people whose medical expenses exceed their ability to pay. Many senior citizens have chronic health issues. Even though most senior citizens have Medicare, they may still have substantial out-of pocket costs, such as deductibles and co-payments. The Medicaid program can also help people who are not poor, but who are faced with sudden catastrophic health care expenses and have no other insurance to cover the costs of necessary hospitalization, care or treatment. MEDICAID IS RETROACTIVE In some cases, Medicaid can help pay your medical bills after you have received services. Medicaid is retroactive up to 3 months prior to the Medicaid application date. Medicaid will look at your income and assets on the day you received services or treatement to determine if you are eligible. Covered Medical Expenses Might Include: Personal Home Care Personal Emergency Response System Nursing Home Care Prescription Medicines Dental Care Routine Foot Care Medical Supplies/Equipment Health Insurance Premiums Preventative Health Care Hospital Care/Clinics Medical Day Care Chiropractors Transportation to and from medical appointments Other Services as Needed Applying for Medicaid and determining whether you satisfy the eligibility requirements can be a complicated process. In determining your eligibility, Medicaid is primarily concerned with: 1) Your amount of medical expense 2) Your Assets 3) Your Income What kinds of things will Medicaid need to see at the time of application? -Identifying information such as Birth/Baptismal Certification -Medicaid, Social Security, Insurance Cards Marriage Certificate/Spouse's Death Certificate -Power of Attorney form -Deed to House/Automobile Title -Veteran's Discharge Papers -All statements of all resources (bank statements, CDs, stocks/bonds etc) going back 36 months; with explanations of all deposits or withdrawals $500 and over -Verification of all current income -Verification of trusts created in the past 5 years; -Verification of a pre-paid burial plan (preferably in the form of an irrevocable burial trust*) -Verification of face and cash values of all life insurance policies -Any unpaid medical bills (retroactive 3 months) -Verification of health insurance premiums --Statement of Medical Necessity from a doctor -Current PRI (Patient Review Instrument) for SNF/rehab facility admissions Click here to return to the Elderplanning Home Page