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Medical Assistance


MEDICAID CHRONIC CARE SECTION
(PUBLIC HEALTH INSURANCE PROGRAMS)

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.

ELIGIBILITY CRITERIA
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.

BENEFIT LEVELS
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.

HOW TO APPLY FOR NURSING HOME OR HOME CARE

MEDICAID BENEFITS

SCHEDULING A PRESCREENING INTERVIEW FOR
ASSISTANCE COMPLETING THE APPLICATION PROCESS

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 a prescreening appointment with Medicaid. If they cannot assist, you can call the Medicaid Chronic Care office at (315)435-3840. 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 prescreening appointment, an application form will be provided to be completed and brought back at the time and date of the prescreening. The application will be asking questions regarding the income and resources of the person who is in need of Medicaid benefits. Documentation of income and resources will be required and should be brought with you to the prescreening interview along with the completed Medicaid application. The agency can accept legible photocopies, but if originals are provided they will be copied and returned.

WHO ATTENDS THE PRESCREENING INTERVIEW
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.


WHAT DOCUMENTS YOU WILL BE ASKED TO PROVIDE
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 a prescreening 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, monthly statements for all financial accounts for the

     60 months prior to the date of application must be provided. This includes accounts currently closed

     but that were active at any time in the 60 month look back period. 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.

DAY OF THE PRESCREENING INTERVIEW
At the prescreening 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.

RECEIVING A FINAL DECISION
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.

RENEWAL OF ELIGIBILITY & REPORTING RESPONSIBILITY

If you are found eligible for ongoing Medicaid benefits or another Public Health Insurance Program you will be required to re-establish your eligibility at regular intervals as determined by the New York State Social Welfare law. This is called “ Renewal”. You will receive notification of your renewal and a renewal form by mail. It must be returned by the date in the notice for your benefits to continue. Social Services law requires that you report any changes in your income, resources, third party health insurance, family composition and residence to the Medicaid office. You may also be contacted by the department if a computer income match indicates a change in your circumstances.

If you have any questions, you may contact the Medicaid Chronic Care Unit at 315-435-3840.

Rev. 4/5/11



 
 
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  Copyright © 2001- 2014 Onondaga County, New York  All Rights Reserved.   |  Ongov.net  |  Privacy Statement | Directions & Downtown Parking Maps