The LTC Medicaid Process
JG Medicaid Consulting LLC
Jul 07, 2021
Colorado - Western Slope
Email US
Click to Email Us
The Long Term Care Medicaid application process requires various facets be completed.
When an individual applies for Long Term Care Medicaid to help pay for Nursing Home Care, Assisted Living Care, or in-home care, a financial application is completed by (or for) the client. The application initiates a process to determine the clients financial AND functional eligibility.
A functional assessment will be scheduled, after the financial application is submitted, in which a case manager assigned by the county will meet with the person-in-need. The applicant must meet a nursing home level-of-care to qualify for Long Term Care Medicaid, but this DOES NOT mean that he or she be admitted to a nursing home. The case manager gathers information from the client, the family, and the clients doctors to help make the functional determination. A case managers level-of-care approval is required for the financial technician to move forward with a Long Term Care approval.
During the financial process of the clients application, all assets and income for the individual, or both spouses, will be reviewed. Assets may include (but are not limited to); checking, savings, certificates of deposit, stocks, bonds, promissory notes, real property (such as: homes, cabins, bare land, time shares, etc.), mineral rights and vehicles (i.e.: cars, trucks, ATVs, boats, trailers, campers, RVs, etc.) Proceeds from the sale of a home within the last five years must also be disclosed and a spend down of these funds provided. Please note that gifting of any kind is NOT allowed by Medicaid and will create a penalty period if one occurs.
Any types of trusts with the clients and/or spouses names on them must also be disclosed, copied, and submitted by the county technician to the State of Colorado for an official review. Trust types may include; Family, Irrevocable, Revocable, Disability, Special Needs, or Income. The States review may take several weeks, so its imperative that the document along with an up-to-date asset list be submitted early in the process to allow the State sufficient time. The States approval is required for the technician to move forward with a Long Term Care approval.
The financial technician may review assets for the client/spouse looking back over the last five years, so records requested as verification may be required. The State of Colorado has set a 5-year look back period in its rules and regulations, so if the county technician deems it necessary, records may be required for this time period. While this doesnt happen all the time, it can happen so a new applicant should be prepared to gather the information upon request.
Being adequately prepared when a financial application is submitted is half the battle of getting positive results for the application. Responding timely to verification requests from the technician is the other half of the battle. Most times, applications are not as complicated as what is listed above and the process can move along swiftly. The county technician is required to process a financial application to completion within 45 days, whether its with an approval or denial.
Editors Note: This article was submitted by Joell Gray, owner of JG Medicaid Consulting, LLC. She can be reached at 970.216.4999, or by email at jg.ltc.med@gmail.com.
Other Articles You May Like
Food Bank of the Rockies Nourishing Communities on the Western Slope
Of the 32 counties we support in Colorado, 13 are located west of the Continental Divide and served by our phenomenal team in Grand Junction. Through mobile pantries and partnerships with more than 110 Hunger Relief Partners in this region, our team is able to meet the specific needs of these communities and bring food where it is needed most. We know that budgets can be stretched thin these days, so by leveraging the power of community and through programs like Everyday Eats for Older Adults, Food for Kids, mobile pantries, and more, Food Bank of the Rockies provides food to 1 in 9 people facing hunger in Colorado.Need a referral to your local food pantry? Do you want to apply for SNAP benefits? Want to learn more about our programs? Interested in volunteering or making a donation? We would love to hear from you! To contact us, please call 970-464-1138 or 877-953-3937 (toll-free) or visit foodbankrockies.org. Editors Note: This article was submitted by Food Bank of the Rockies. For more information, please call 303-371-9250.
Will Federal Medicaid Changes Affect Colorados Long-Term Care Medicaid? Heres the Answer
Will Federal Medicaid Changes Affect Colorados Long-Term Care Medicaid? Heres the Answer President Trumps One Big Beautiful Bill (OBBBA) certainly includes far-reaching revisions to Medicaidcuts to provider taxes, new work requirements, tighter eligibility checks, and billions in savings over a decade. But Colorados long-term care Medicaidcovering nursing homes, home health, and other LTSS (long-term services and supports)has unique state safeguards that ensure it remains insulated from these changes. 1. Federal Cuts Mostly Affect Expansion and Non-Elderly AdultsThe OBBBAs primary targets are Medicaid expansion, non-disabled adults, and children, via work requirements and cost-sharing policies. These reforms are expected to phase in during 20272028. In contrast, long-term care beneficiariestypically seniors and people with disabilitiesfall under separate eligibility categories that the bill doesnt restructure. 2. States Can Shield Long-Term Care FundingColorado funds long-term care services through its Medicaid waiver system. The OBBBA reduces providers taxes and places new caps on expansion enrollment, but it does not limit waivers for nursing homes or home- and community-based services. Even without adjusting, Colorado can preserve funding by prioritizing these essential services over general expansion. 3. Colorados Bipartisan Commitment to Aging ServicesColorado has a long-standing commitment to supporting seniors and people with disabilities. In recent years, the state has steadily increased its share of state funds to match or exceed federal contributions, especially for the elderly population. With broad political consensus, any state-level attempt to curtail waivers would be unlikely. 4. Historical Stability Through Waiver ProtectionsSince implementing the Home- and Community-Based Services (HCBS) Medicaid waiver in 2004, Colorado has used it to support aging in place and reduce institutional costs. These waivers have remained stable across administrations and funding changes. Theres no indication that Trump-era reforms would dismantle this proven framework. 5. National Context Supports StabilitySources like KFF confirm that while OBBBA cuts the Medicaid expansion rate from 90% to 80%, and imposes red tape on enrollment, it does not overhaul LTSS (long-term services and supports). Even health-policy experts acknowledge the targeted nature of the reformfocused on non-elderly groups, not those needing long-term care. Bottom Line for Coloradans Trumps Medicaid changes will significantly affect parts of the system serving non-disabled adults, especially in expansion states. But Colorados long-term care Medicaiddriven by federal waivers, state obligations, and a bipartisan mandatestands apart. Residents access to nursing home care, home-based services, and support for people with disabilities is not at risk.
Financial Planning for Long-Term Senior Care
The rising cost of senior care can come as a shock to many families. Whether your loved one wishes to age in place, transition to assisted living, or explore memory care options, having a financial plan in place is critical to ensuring quality care without unexpected burdens. Planning ahead provides families with more options, greater peace of mind, and the ability to align care decisions with long-term goals.First, its important to understand the typical costs of various types of care. According to Genworths most recent Cost of Care Survey, the national median monthly cost for assisted living is over $4,500, while in-home care can cost between $25 and $30 per hour. These figures vary by region, and services like memory care or skilled nursing can cost significantly more. This makes early planning essential.Families should begin by assessing current income, savings, and assets. Does your loved one have a retirement plan or long-term care insurance? If not, consider whether existing resources could be stretched to cover care with support from public programs. Some seniors may qualify for benefits like VA Aid and Attendance, which helps veterans, and their spouses pay for personal care services. Others might eventually become eligible for Medicaid, which can help cover nursing home or in-home support if income and asset limits are met. Its also important to know that Medicare typically does not cover long-term care, only short-term rehab or skilled nursing following a hospital stay.Working with a financial advisor or elder law attorney can help families build a strategy that factors in care needs, housing, and estate planning. The National Council on Aging offers excellent resources, including the BenefitsCheckUp tool, to help seniors identify financial aid and local services. When financial planning is approached with care and clarity, it not only protects assets it protects dignity and choice for your aging loved one.If you have any questions, please call us at 303-957-2555.