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After You Apply for Medicaid for Nursing Home Care:

Posted December 5, 2018

Your local DHS office will decide if you are eligible for Medicaid. They will send you a letter with their decision:

  • within 45 days, or
  • within 60 days if you have a disability.

The nursing facility must be certified by Medicaid to provide the care you need. Medicaid only pays for services that are medically necessary. Medicaid only pays for nursing facility, MI Choice waiver and the Program of All Inclusive Care for the Elderly (PACE) services when you have been determined medically/functionally eligible via the Michigan Medicaid Nursing Facility Level of Care Determination. If you are eligible, you will receive a mihealth identification card. You should also receive a notice from your caseworker advising you of the amount you are required to pay toward the cost of your care while in the nursing home. This is called a Patient-Pay Amount.

Your nursing facility will bill Medicaid for the portion of the bill you are not expected to pay. If you have applied for Medicaid, you must inform your medical provider (doctor, hospital, pharmacy, nursing facility, etc.) that you have applied for Medicaid prior to receiving medical service. You must give your medical provider a copy of your mihealth card or approval letter as soon as it is received. Your medical provider needs this information to receive prompt payment for medical services provided to you.

This information is also necessary in order to issue you a refund if you pay for the services between the date you file an administrative hearing request with DHS after they issued an incorrect Medicaid denial, and the date of an eligibility determination resulting from your hearing request. It is the responsibility of the medical provider to submit any outstanding medical bills, using Medicaid billing procedures, to the Medicaid office within 12 months from the date of the Medicaid covered service. Exceptions to the 12-month billing policy may be authorized if the delay in billing is caused by an agency error or as the result of a decision handed down by court order or administrative hearing decision.

www.michigan.gov/nursingfacilityeligibility

 

What Assets Does DHS Count?

Posted November 1, 2018

Liquid Assets that DHS counts when considering your application for Medicaid for Nursing Home Care (Also known as Countable Assets):

  • Cash, savings accounts and checking accounts
  • Credit union share and draft accounts
  • Certificates of deposit
  • U.S. Savings Bonds
  • Individual Retirement Accounts (IRA) and Keogh plans

Equity Assets:

  • Real estate (other than your home)
  • More than one car
  • Boats or recreational vehicles
  • Stocks, bonds and mutual funds
  • Land contracts or mortgages held on real estate sold See Appendix II for more help determining your assets.

A list of common assets DHS does not normally count are (also known as Excluded Assets). Your primary residence for Medicaid eligibility, but do count the equity when determining Medicaid payment for long-term care services.

  • Personal belongings and household goods
  • One car
  • Burial spaces and certain related items for you and your immediate family.
  • Up to $1,500 designated as a burial fund for you or your spouse, if you have one.
  • Irrevocable prepaid funeral contract.
  • Value of life insurance if total face value of all policies is $1,500 or less per owner, or term insurance of any kind.

www.michigan.gov/nursingfacilityeligibility


Prearranged Funerals and Medicaid for Nursing Home Care:

Posted October 23, 2018

You can prearrange your funeral and still get Medicaid. How much money you can protect, and for whom, depends on which arrangements you choose. Someone in the funeral or insurance business may be able to give you more information. These are four commonly used arrangements:

  • Prepaid funeral contract - Irrevocable funeral contracts are not counted if the contract is for your expenses and the amount of the contract is less than the funeral maximum in BAM 805. You will need to contact your DHS caseworker since the allowable amount of the contract changes each year.
  • Life insurance - Michigan law allows you to assign money from your life insurance for your funeral costs. There is a limit to the amount you can assign. You can usually do this by transferring ownership to a trust when you buy the insurance. If you have a spouse, you may also protect funds to pay their funeral costs.
  • Buy burial space items - You can buy items for burial. Examples are a casket, a burial plot, a vault, a headstone, and opening and closing the gravesite. These items do not count as assets when you buy them for yourself, your spouse, and are limited for members of your immediate family.
  • Designate a burial fund - A burial fund pays for funeral costs not covered by allowable burial space items. A separate savings account for a burial fund for you or your spouse does not count as an asset. The limit is $1,500. The limit includes:
  • The face value of life insurance that was not counted.
  • The amount paid for an irrevocable funeral contract.
  • The amount of insurance for burial costs

www.michigan.gov/nursingfacilityeligibility

 

 

 

 

 

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