MEDICAID CHRONIC
CARE SECTION
(PUBLIC HEALTH INSURANCE PROGRAMS)
Onondaga County Office Building 6th Floor
600 S. State St
Syracuse, New York 13202
Hours: 8:00 AM- 4:00 PM (Monday-Friday)
Telephone: (315) 435-2928 Fax: (315) 435-8530
The Medicaid Chronic Care Unit processes Medicaid applications
for those individuals who are seeking help in paying for
nursing home or long term home health care services.
WHO IS ELIGIBLE?
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
Applications may be mailed to our office. A face to face interview is not required. A pre-screening interview appointment is a courtesy service but is not required.
SCHEDULING A PRESCREENING INTERVIEW FOR
HELP 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 help you
with getting a prescreening appointment with Medicaid. If they can't help,
you can call the Medicaid Chronic Care office at (315)435-2928. The office is located on the 6th floor of the County Office Building, 600 S. State 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's in
need of Medicaid can't 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 WILL YOU 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
• 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 ownedby 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.
Email Us Your Documents:
If you would like to email us documents, please read these instructions and send your documents to the email address below;
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 315-435-2928.
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