MEDICAID ELIGIBILITY & APPLICATION PROCESS


The objective of our company is to help clients avoid nursing home spend down.  Our
paraprofessionals know the specifics of the Medicaid laws regarding the eligibility and
application process.  They understand the intricacies involved and what is at stake.  In
addition, they have years of experience in multiple states, obtaining eligibility for over
300 clients WITHOUT having to appeal the decision.  However, there are times when a
client comes to us after the process has begun, and the inevitable decision is not
favorable.  Our skilled paraprofessionals can assist with the appeals process for an
adverse decision, as well.

What a Non-Attorney Representative CAN do under state and federal
administrative law...

  • INFORM you of state and federal Medicaid rules and regulations

  • PREPARE and SUBMIT your Medicaid application

  • REPRESENT applicants and/or their spouses before the local  Medicaid agencies

  • ASSIST in hospital discharge and nursing home placement

  • ASSIST Elder Law attorneys in drafting necessary, appropriate legal documents,
    such as power of attorney, deeds, wills, trust, and contracts

  • IMPLEMENT estate planning done by an Elder Law or other attorney

  • ASSIST attorneys in nursing home discharge hearings or Guardianship hearings

  • RECEIVE instructions/correspondence and act as a liaison between you and the
    Medicaid agency

  • ACCESS your Medicaid agency file and it's content

  • COMMUNICATE, VERIFY, AND DISCLOSE information necessary for eligibility
    determination

  • REQUEST and PREPARE for state or local Fair Hearing for applicant/recipient

  • REPRESENT applicant and/or spouse at state or local Fair Hearing

Benefits of using a Non-Attorney Representative…

  • SAVE hundreds (perhaps, thousands!) of dollars in attorney fees

  • MAXIMIZE benefit awards and benefits to applicants

  • AVOID delay and denial of benefits



MEDICARE APPEALS PROCESS

The appeals process for Medicare claim denials has changed.  Beneficiaries no longer
argue their claim before an Administrative Law Judge.  Instead, appellants, despite age
and disability, are expected to video conference their appeal hearing.  An appellant
may request a face-to-face hearing but few will likely be granted.  Even if the request
for a face-to-face hearing before a Hearing Officer is granted, the appellant must travel
to only 1 of 4 (formerly, 140 at various locations across the country) to the nearest
hearing location—Cleveland, Ohio!

  • Experienced paraprofessional will record & conduct a video conference for a
    Hearing Officer

  • MEDICURITY representative will travel to Cleveland, Ohio in place of denied
    beneficiary, if granted a face-to-face appeal before a Hearing Officer

  • An experienced voice who has represented disability beneficiaries in dozens of
    administrative law proceedings before a Hearing Officer

  • Avoid high legal fees
REPRESENTATION