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Medicaid Planning and Eligibility for Long-Term Care in Ohio

Are You Having a Hard Time Understanding Medicaid?

Medicaid is intended to provide free or low-cost healthcare to low-income individuals. Federal and state governments both fund Medicaid, with each state opting into Medicaid and administering its own Medicaid system.

Since each state operates its own Medicaid program, eligibility rules, coverage, and application process may vary from state to state.

In order to qualify for Medicaid in Ohio you must be a United States citizen or meet Medicaid for non-citizen requirements. Medicaid is intended for individuals with low income, pregnant women, infants, and children, as well as the elderly or people with disabilities.

In Ohio, for individuals in nursing homes or institutionalized to qualify for Medicaid, they must have an income of less than $2,829 per month and an asset limit of $2,000. Married couples with only one spouse applying must meet the same requirement as an individual who is applying, except the non-applicant spouse must have an asset limit of $154,140.

A married couple, with both spouses applying for Medicaid assistance, must have a combined monthly income of up to $5,658 and an asset limit of $3,000.

How Do You Apply for Medicaid in Ohio?

There are a few ways to apply for Medicaid in Ohio. You can apply online, in person, in writing, or by phone. No matter how you choose to apply, your process will be the same.

First, you will want to read the application as thoroughly as possible. Putting in the wrong information can result in delays or your application being denied. You will want to include any pre-existing insurance you may already have. If you are over 65 or have a disability, you will need to provide proof of your age or disability.

Next you will need to sign and date your application and send the application and any additional materials to your local county Job and Family Service office. You can turn your application in by mail, fax, or drop it off in person.

Your application will be processed. If the person processing your application needs more information, supporting documentation, or clarification, you may be contacted either by phone or mail to supply this information.

You can check on the status of your application either by calling the hotline or logging into your Ohio Benefits account.

Why Would Your Medicaid Application be Denied?

It may be frustrating to go through the Medicaid application process and even more infuriating if your application is denied after you do all the work and wait patiently for any response.

You may be wondering why your Medicaid application would be denied. Here are the most common reasons your Medicaid application could be denied:

  • Your Medicaid application was incomplete or contained errors.
  • You failed to provide the necessary documents required by the state of Ohio in a timely manner. This can be validation of your age or disability.
  • If you applied for Medicaid because of a disability, the agency may not believe you are disabled.
  • You don’t meet the limits of either your income or your assets, making you ineligible. 
  • You transferred assets for less than market value within five years of applying for benefits.
  • Internal error while processing your application.

While not all of these reasons would require you to get legal counsel to figure out a solution, some may require a deeper understanding of the legal system that props up the Medicaid process in Ohio. 

What Does the Appeals Process Look Like?

If your Medicaid application is denied, the denial must be provided in writing, and the reasons for the denial must be explained. This denial letter must also inform you of your right to appeal as well as how to start the appeals process.

In Ohio, you begin your appeals process by asking for a state hearing. At a state hearing, an officer will listen to you, or your spokesperson talk about why your application being denied may be wrong. The agency will attempt to explain to you why they reached their decision and why they don’t think their decision is wrong.

You have the right to hire legal counsel for the appeals process and have them represent you during the state hearing. Working with an attorney, you can go to your hearing well-prepared with all of the proper documentation.

Do You Need to Hire a Lawyer When Applying for Medicaid?

An attorney is not required when applying for Medicaid. In fact, you will not have a need for an attorney until your application is denied.

When you disagree with the denial of your Medicaid application, then you need a professional who understands the system and has your best interests in mind.

Call 614-228-3664 to schedule a case evaluation with the compassionate lawyers at Lawrence Law Office. Our team is here to help you understand not only Medicaid and why you may have been denied but also how to appeal your denial in a way that will increase your odds of turning a denial into the assistance you or your loved one needs in order to enjoy their later years.

Our team will help you take care of the process. We will instruct you on getting the necessary documentation and supporting evidence to prove that you not only qualify for Medicaid but could benefit from the support it would provide.

You won’t be going to your hearing alone when you work with Lawrence Law Firm. We will be in your corner, working towards the outcome you deserve!

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