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What You Need to Know About the Waitlist for Florida Medicaid Enrollment

Jan 19, 2022 | Medicaid Planning Legal Blogs | Elder Law P.A

The Sunshine State has a population of roughly 21.5 million, and, of these, 22 percent are seniors over the age of 65. Of the roughly 4 million seniors in Florida, around 3 million are expected to seek some type of nursing care, either at home, in a long-term care facility, or at an adult care center. To pay for the cost of long-term or home care, the seniors will either have to pay out-of-pocket or apply to Medicaid enrollment Florida. This federal agency has proven to be a reliable source of funding for seniors who cannot afford to pay out-of-pocket for long-term care assistance.

Each year, the number of people (both seniors and those under age 65) applying for Florida Medicaid enrollment has been increasing. And, as the country continues to grapple with the Covid-19 pandemic, it is anticipated that over the next few years, there will be more seniors who will need some type of Medicaid managed care plan.

The Florida Medicaid Waiver Program is a program whereby those eligible for Medicaid enrollment Florida can obtain long-term care assistance either at home or from community-based (ALF) services. It is actually known by another name, the “Statewide Medicaid Managed Care Long-Term Care Program” or (SMMC-LTC). This waiver and waitlist apply only to non-nursing home services covered by Medicaid. This does not apply to nursing home care. Medicaid assistance for nursing home care has no waitlist.

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Number of Senior Medicaid Applicants

According to the latest statistics, economists estimate that nearly 4 million seniors will be considering Florida Medicaid enrollment this year and that number is expected to increase by 4 percent the following year. The higher-than-anticipated Florida Medicaid enrollment has stressed the state’s funding levels and, while some of the money will be available through the federal government, it is not fully known how much the federal government will contribute. The bottom line is that there simply isn’t enough funding to assist all the people who are applying for Medicaid assistance. It is expected that there will be a waiting list for enrollment and some seniors will have to wait their turn to obtain Medicaid long-term benefits.

At the same time, Florida is limiting its reliance on federal Medicaid money. While the funding has helped the state cover the increased Medicaid enrollment caused by the Covid-19 pandemic, it has restricted the Sunshine state’s ability to decrease the number of people relying on state programs.

Other Medicaid Applicants

The Sunshine State has also seen sudden spikes in Florida Medicaid enrollment of children ages 14 and older because they come from poor families or the Needy Families Program (previously known as Welfare recipients).

Since the Covid pandemic started, there has been huge growth in young people seeking Medicaid assistance. Since the Sunshine State has been accepting money from the federal government, it is not able to terminate any individual who had already been enrolled in the Medicaid program the previous year. All this affects seniors who also want to apply for Medicaid long-term care benefits; there simply is not enough money to go around.

Economists are hoping that the Covid-19 pandemic will ease next year and fewer people will apply for Medicaid benefits, but whether this will happen is not known.

Already there is a long waiting list of applicants to the various Medicaid programs. While first-come, first-serve will apply to many applicants, the eventual selection of each Medicaid applicant will be based on the urgency of medical need.

WHAT DOES THIS WAITING LIST MEAN FOR SENIORS?

In simple words, if you are a senior, you should consult with an attorney specializing in elder law to determine if you are, first, eligible to apply for Medicaid long-term care and then apply. The application process can be burdensome, complex, and time-consuming; therefore, it is highly recommended to retain an experienced Medicare attorney to assist you.

Every single Medicaid application can take many months before receiving an answer. The solution is to get on the Medicaid waiver list, which assesses each individual based on need. Once on the waiting list, a phone call may come within a few weeks or after a few months. A preliminary assessment is done via the phone and a priority score is given. If during the waiting time, your health condition worsens, you can call and have your waiting status moved up.

The Application Process

No matter what type of Medicaid program you are applying to, the application process is not straightforward and requires an enormous amount of documentation. To collect the documents itself can easily take 3-6 months. Working with an attorney who specializes in elder care can help expedite the process. The next thing you need to know is that you have to be fully transparent about your finances. Medicaid officials do not take it kindly when all income is not reported, and you can even be charged with fraudulent activity for omitting certain incomes.

Documents That You Will Need

1. Birth certificate (a driver’s license may suffice for ID).

2. Proof of US citizenship.

3. Proof of current residency: this means you will need copies of your rent, mortgage, utility bills, or lease contract.

4. Proof of medical disability or chronic illness: this requires a formal letter from your healthcare provider attesting to your illness, type of disability, and what type of nursing or home care you may require.

5. All retirement income which includes:

  • Letter from Social Security Administration as to how much you are receiving
  • Pay stubs for all other income, including private pension
  • The stub of your government pension
  • Tax receipts for the past 3-5 years
  • All your investments

6. Property ownership. You will need the deed and tax assessment on your home. Anything attached to the home, like a mobile home, has to be included. You will also need documents about the value of the home, any mortgage, loans, etc.

  • Personal property includes the number of cars and their value.
  • All antiques and collectible items need to be verified for their value

7. Bank accounts. You will need statements regarding your:

– Checking account, savings account

– CDs

– Dividends paid out each year

– Stocks, bonds

– Money market accounts

– All other investments

If you have more than $2,000 in cash, you are not eligible for Medicaid benefits.

8. Life insurance policy. You must get the company to write out the cash value of the policy. If it is more than $5,000, then your application may be rejected.

9. Burial expenses for you and your family. Medicaid does allow up to $5,000 in burial expenses but you must have evidence of a pre-planned burial contract.

10. Medical insurance – the type and how much in premiums you are paying each month.

CONCLUSION

As you can see, the amount of documentation is extensive and does require time to collect. With a potential waiting list for Medicaid enrollment Florida applicants are likely to increase in the coming year, the sooner you start with the Florida Medicaid enrollment application process, the higher up you will be on the waiting list. Once you have the documents and eligibility confirmed, a lawyer can help you get on the waiting list. From there, it is only a matter of time before your name is called by Medicaid. Consult with an experienced Medicaid attorney as to how to proceed and know your legal rights. Call Elder Law, P.A. today at 1-561-588-7512.

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