Have you ever had a case that you thought for sure the applicant
would be eligible medically for Medicaid but ended up not scoring the necessary points to be eligible? The medical eligibility for long term Medicaid is a part of the application process that is worth paying close attention to.
Many skip preparing for the medical eligibility and end up getting denied even though the applicant truly is in need of care and meets the
criteria. Remember that success depends upon the documented proof that the applicant needs daily HANDS-ON CARE.
Long term Medicaid in every state requires the burden of documenting that the applicant is at a nursing home level of care. Does this mean that the applicant must BE in a nursing home? Of course not, but it does mean that the provided documentation must illustrate the risk of institutionalization, medical diagnosis, daily need of care and any behavioral issues requiring intervention.