First, review the applicable Medicaid document checklist below:

– Checklist for single applicant

– Checklist for married applicant

Next, begin gathering the documents as soon as possible. Please send copies of all documents to Eldercare Resource Planning. Note the following:

– We will request copies of all documents applicable to your case (refer to the checklist above)

– Additional documents may be requested

– Please send fully legible documents (not blurry)

– Do not send copies that show sticky notes or any obstruction of the document

– It is important that you do not mail us any original documents. If you choose to mail us documents send photocopies. If we receive originals we will not be able to return them to you

– Lastly, please do not send documents directly to Medicaid unless instructed by your Specialist

Please securely send documents to Eldercare Resource Planning using one of the following methods:

Easily upload documents to our Leapfile secure file sharing page (preferred)

– Go to: http://eldercareresourceplanning.leapfile.net

– Click SECURE UPLOAD

– Enter the recipient email for your Specialist or their Administrative Assistant

– Enter message, upload your files, and click send

Fax documents to:

– 415-484-7048. Please include a cover letter that states who the fax is TO and FROM

Mail documents to:

– Eldercare Resource Planning

– 9450 SW Gemini Dr. PMB 73315

– Beaverton, Oregon 97008-7105

Be sure to address letters to the attention of your Eldercare Resource Planning Specialist. Be advised that regular postal mail takes approximately one week to be received by your Planning Specialist.

The look back period is Medicaid’s way of deciding if the applicant gave away assets to become eligible

– Many states will require financial statements for the full look back period

– The look back period in most states is 60 months (in California it is 30 months)

– Certain cases do not require documentation for the full look back period

– Please be prepared to provide the past 3 months of financial statements. Your Specialist will determine if more statements are needed

After eligibility is finalized, we will complete the Medicaid application and send it to the appropriate agency. The date of submission depends on various considerations:

• Time it takes to obtain appropriate documentation
• Complexity of financial planning for your case
• Time needed to implement eligibility planning
• Policies for nursing homes, such as Medicaid pending (varies by facility)

During the pre-application stage your Specialist will carefully review the case and give you an estimated submission date.

Throughout all stages, we will continually give you status reports. You will always know exactly what is happening and when.

In general, the application will only be submitted when the individual applying is financially and functionally eligible for the benefit.

There are some exceptions and your Specialist will inform you of all options.

In general, you will not need to communicate with Medicaid. Your Specialist will be authorized to communicate with the state or county agency.

There are situations that require a family member to work with a 3rd party organization — this is common with Medicaid waiver programs for home care. If this is needed, we’ll guide you through the process.

We also ask that you please check with your Eldercare Resource Planning Specialist before taking any direct action with your state or county Medicaid agency during the application process.

After the application is submitted, we will contact the agency to ensure that the application was received and is being processed in a timely manner. Your Specialist will work with the caseworker and submit any additional verification materials that may be requested.

For assisted living or homecare cases, we will facilitate the enrollment process, which usually requires a level of care assessment and may require referrals to 3rd party agencies.

Please note that your second payment will be due at the time of submission.

The date of an approval depends on several factors:

• Type of case
• Time required to plan for eligibility
• Processing time of each Medicaid agency

After your case is thoroughly reviewed, your Specialist will give you an estimate of approval time.

If you are approved — Your Specialist will review the decision letter ensure that the benefit has been calculated correctly. If we find a discrepancy, we will follow up with the caseworker for a recalculation of the benefit.

If you are denied — It is not uncommon to receive an initial denial. Reasons for a denial include: denial notice that is not related to the long-term care benefit, such as a denial for a health savings program; an expected denial due to a spend down strategy, penalty period; or the Medicaid agency has made an error. We will carefully review any denials and take steps to reopen the case.

Annual Redetermination — Once approved, benefits do not automatically renew each year, therefore redetermination paperwork must be submitted annually to Medicaid. Your Specialist will discuss this with you upon approval and will confirm the annual renewal date.

Eldercare Resource Planning offers an additional service to assist with the annual renewal process. If interested please reach out to your Specialist when you receive the annual renewal / redetermination paperwork from Medicaid

Intake Questionnaire or document checklist questions:

Please contact your assigned Specialist or their Administrative Assistant. You will receive and email with their contact information.

General Medicaid financial eligibility, spend down, and other planning tools questions:

During your introductory call the Specialist will briefly discuss eligibility strategy options that may be needed.

After your Specialist thoroughly reviews your Intake Questionnaire and documentation he or she will schedule follow up calls and provide you with detailed information for your case.

You may always reach out to your Specialist or their Administrative Assistant. We are here to help!

Each client’s case is assigned to one of our expertly trained Medicaid Planning Specialist.

He or she will reach out to you by phone for an introductory call. You will also receive an introductory email with their contact information. Please keep an eye on your inboxes for this welcome message.