APPLYING FOR MEDICAID
Applying for Medicaid will be a must for a community based waiver, as this is how the waiver is supported.
You can apply online, using CommonHelp. Apply for Health Care Only. You will also need to complete Appendix D if the individual is 19 or over.
Or make a phone call……you can apply for Medicaid by calling 1-855-635-4370.
There is always the paper application. Complete Financial Application for Adult Medicaid AND Appendix D and take to your local DSS office and request a screening for the EDCD Waiver or for Long Term Care.
Now, let’s talk specifics. When a parent is completing the paper application or online, remember this is about your child. Not about you. This is based on your child’s income and or assets. You do not need to indicate any info regarding the parents income. Once completed and submitted, the Medicaid worker has up to 45 days to process the application.
It is very important for families to remember in order to retain Medicaid benefits under the EDCD Waiver they must be utilizing the personal care attendant services, and if they do not use these services at least every 30 days, they could lose their Medicaid benefits. Additionally, you will have an annual review by your Medicaid worker. It is VERY IMPORTANT that you watch for mail from DSS around the time of the annual review
and be sure to complete the review and send back in a timely manner to DSS in order to
maintain Medicaid benefits.
You do not need to apply for Medicaid before requesting a screening. We would suggest that you call for a screening first to find out how long it will take to get an appointment. If you apply for Medicaid, but it takes more than 45 days to get a screening, the Medicaid application may be denied due to not having a DMAS 96 indicating they met criteria and approved for the waiver.
*** Make sure you write EDCD/Long Term Care Screening at the top of the form***.
Find your Local DSS here.
Some individuals may have to pay for a part of the monthly cost of their waiver services, if they have “excess income” as determined by the Department of Social Services. This is known as “patient pay.” DMAS deducts any patient pay from their reimbursement to the provider (or employee in the case of Consumer-Directed Services), who must in turn collect it from the individual. The CSB Support Coordinator should inform you if this is owed.