John H. Mulroy Civic Center, 8th Floor
421 Montgomery St,
Syracuse, New York 13202
Hours: 8:00 AM- 4:30 PM (Monday-Friday)
Telephone: (315) 435-3840 Fax: (315) 435-8530
The Medicaid Chronic Care Unit processes Medicaid applications
for those individuals who are seeking assistance in paying for
nursing home or long term home health care services.
Financial eligibility is determined
based on the income and resource standards governing the Medicaid
Program. A Supplemental Security Income recipient is granted Medicaid
based upon his/her certification for SSI Benefits.
The amount of assistance that the
Medicaid program will pay toward the cost of nursing home and/or
home care services is determined using a comparison of the available
income and resources of the applicant against the cost of the medical
services needed. Since each financial and medical circumstance
is unique, the regulations and policies governing what assets are
exempt and what assets are used in the determination of eligibility
vary, therefore, income and resource standards are not listed here.
Anyone who needs financial assistance in paying for nursing home
or long term home health care services is encouraged to contact
our office for consultation regarding their specific need for benefits.
In Onondaga County, if you
need to apply for Medicaid for a person who is already in a hospital,
Nursing Home or receiving services from a Home Care provider, someone
on the staff of one of these organizations usually can assist you
with obtaining an appointment with Medicaid. If they cannot assist,
you can come to the Medicaid Chronic Care office to request an
appointment. The office is located on the 8th floor of the Civic
Center, 421 Montgomery Street, Syracuse, New York.
When you request a Medicaid Chronic Care appointment you will
be given an application form to be completed and brought back at
the time and date of the interview which you will need to schedule.
The law requires that you be interviewed in person. You will also
be asked questions regarding the income and resources of the person
who is in need of Medicaid benefits. From those questions, a list
of required documents that must be provided to determine eligibility,
will also be given along with the application. These documents
should be brought with you to the interview along with the completed
Medicaid application. The agency can accept legible photocopies,
but if originals are provided they will be copied and returned.
If the person who is in
need of Medicaid cannot attend the interview, the interview may
be attended by someone who has Power of Attorney or who has written
authorization enabling them to represent the applicant. The Power
of Attorney papers, written authorization to represent, and identification
of the authorized representative must be provided at the interview.
The
law requires that you provide documentation to verify your sources
of income, your assets, birth date, marital status, and citizenship,
as well as some other items. Below is a list of some of the items
that will be required. You will receive a detailed list when you
receive the application to complete and an appointment date and
time.
• Birth certificates for the applicant
and spouse
• Social security cards for the applicant and spouse (optional)
• Alien registration card / I-94 card / Naturalization papers for
the applicant and spouse
• Marriage certificate or separation papers or divorce papers
• Death certificate(s) of spouse(s)
• Veteran Discharge papers for applicant and /or spouse
• Power of Attorney Papers
• Written Authorization to Represent the Applicant
• Medicare and other health insurance cards and verification of monthly
premiums
• Verification of ALL sources of income for the applicant and the
spouse, such as but not limited
to, wages, social security, pensions,
veterans and military benefits, interest and dividend
income. The
gross amounts must be verified, with all deductions, and the frequency
with
which the income is received.
• Verification
of ALL the assets of both the applicant and spouse MUST be documented.
If you are seeking nursing home services, account
statements for all accounts currently active and those that were active within
the last 36 months prior to the date of application must be provided.
If the applicant or spouse set up a trust or are the beneficiaries
of a trust, the trust document must be provided and all assets owned by the trust must be documented for the 60
months prior to the date of application. Examples of some types of assets
that must be documented are (but not limited to) checking & savings
accounts, CD’s, stocks,
bonds, mutual funds, retirement funds, annuities, Life insurance policies, burial spaces, burial funds, all properties owned, vehicles,
mobile homes and RV’s.
At the interview, the application,
as well as the necessary documentation, will be reviewed with you
in detail. If, as a result of that review, there are more documents
required to determine eligibility, a list of these outstanding
documents will be given to you, and a length of time, usually
two weeks, will be given to provide them. This is called the “pending period”.
If you cannot obtain the required documentation within the time
frame given by the Agency, you can request an extension of time
which will be granted only if the agency feels there is justification
that additional time is necessary.
After all the necessary
documentation needed to determine Medicaid eligibility has been
provided, a decision will be rendered by the Medicaid Office and
a formal written notice will be mailed to the applicant, their
representative, and the facility or home care provider involved.
If you are found eligible for ongoing Medicaid
benefits, you will be required to re-establish your eligibility
at regular intervals as determined by the Department. This is
called “ recertification ”.
You will receive notification in the mail of how to complete your
recertification and the date that your recertification must be
completed.
If you have any questions, you may contact the Medicaid Chronic
Care Unit at 315-435-3840, and ask to speak to a Supervisor.
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