Effective February 1, 2019, persons seeking Medicaid benefits to cover the cost of long-term care in a skilled nursing facility can no longer qualify for up to three months of retroactive benefits. Prior to the change, an application could be filed in one month, and for each previous month the patient met all the Medicaid eligibility requirements, up to three months, retroactive Medicaid benefits could be approved.
Timing is Key
The Florida Agency for Health Care Administration (AHCA) has eliminated the three month Medicaid retroactive eligibility period for non-pregnant recipients aged 21 years and older. With the elimination of the retroactive eligibility, benefit eligibility will begin the first day of the month in which a qualified adult applies for Medicaid, whether they were previously qualified to receive benefits or not. The application date is key.
The elimination of the retroactive benefit period makes it more important than ever for families to seek advice promptly when a loved one is admitted into a skilled nursing facility. Many times, the admission happens after an unexpected crisis, such as a fall or a stroke. Families may feel overwhelmed and not know where to seek advice or what questions to ask.
The belief that Medicare will cover all the expenses for the first 100 days can add to the confusion. Families are often surprised at the end of the 100-day period to receive a large bill for expenses not covered by Medicare, including the sizeable Medicare daily copayments. Prior to this change in the rules, in situations like this, we could file an application for Medicaid and often have the outstanding bill for past services covered under the retroactive benefits rules.
Time is now of the essence when applying for Medicaid. A delay in seeking advice could result in missing months of potential Medicaid eligibility. Contact a certified elder law attorney as soon as your loved needs long-term care.
category: Medicaid Planning & Veterans Benefits