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Common Reasons Medicaid Applications Are Delayed Or Denied


While Medicare will not pay for nursing home care or other long-term care facilities, Medicaid does provide benefits for certain individuals. As such, it is a great option for those who qualify and are trying to plan for long-term care. Qualifying for Medicaid is usually more challenging than many people realize. Below, our St. Petersburg long-term care planning lawyer outlines common reasons why Medicaid applications are delayed or denied.

The Application or Documents are Incomplete 

At one point, Medicaid would patiently wait for supplemental documents as long as they were aware that you were trying to get more information. Today, though, the agency is very quick to deny applications if they are incomplete or if you do not provide the necessary supporting documents right away. For this reason, it is critical to make sure the application and documents are all complete before submitting them.

Not Responding On Time 

If Medicaid has questions after you have submitted your application, they will send a letter to you. You must respond within ten days of the date they sent the letter and not from the date you received it. In some cases, the agency may provide an extension but they will likely not extend that time repeatedly.

Your Income is Too High 

Florida is an income cap state and so, if you are over the limit, there will be no flexibility with your application. Regardless of where income comes from, it is counted towards your Medicaid application. Additionally, there are strict limits on how much money you and your spouse can have. If you are over this limit, your application will be denied. However, there are ways to protect certain assets with careful and proper planning.

You File Too Early 

Long-term care planning is important but you should only apply for Medicaid when you actually need it. If you file before that time, or you are not financially eligible when you file but know you will be in the future, your application will be denied.

You File Too Late 

Medicaid can go back up to 90 days, but not any longer. As long as you were eligible during that time, you can still obtain benefits. On the other hand, if you wait too long to file your application, it will be denied.

You Did Not Properly Fund the Income Trust 

The only solution for having too much income is to establish an income trust. Establishing this trust is only the first step, though. You must also establish an account for the income trust and any money that is over the income cap limit must be directed to the trust. If not, Medicaid will deny your benefits for that month.

Our Long-Term Care Planning Lawyer in St. Petersburg Can Help with Your Application 

If you are having trouble understanding Medicaid’s terminology or you need help filling out your application, our St. Petersburg long-term care planning lawyer at Legacy Protection Lawyers, LLP can help. Call us now at 727-471-5868 or contact us online to schedule a consultation and to get more information.



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