Frequently Asked Questions.

Trust the Medicaid Application Experts

What is the Medicaid program?

Medicaid is a federal and state program administered by the state that covers the majority of an individual's long-term care costs in a skilled nursing home.

How do I know if one will qualify for Medicaid benefits?

Individuals applying for Medicaid must meet strict financial criteria. Generally, a person can have no more than $4,000, a small amount of life insurance, a prepaid funeral, and a car. His or her income must be less than the cost of the private rate of care. Once qualified for benefits, monthly income (such as social security) is paid to the nursing home, less $50 for a personal needs account and the premium on a Medicare supplemental plan and/or private health insurance. The rules are much more complex if the individual has a spouse at home.

Is it difficult to apply for Medicaid?

In a word, YES. There is an extensive amount of information requested by the Medicaid intake office. Medicaid requires up to 3 years of bank statements, copies of all financial transactions, explanations concerning any transfers made during that time period, and copies of legal instruments, such as trusts. Some accounts, such as annuities, require that five years of statements be provided. Failure to comply with requests for information could lead to loss of coverage or denial of benefits. It is not unusual for an application to take 4 - 5 months to complete. With complications, it could stretch to 6 - 9 months.

Is Summit Health Care Solutions a law firm?

NO. We process Medicaid applications and work with families to answer questions presented by Medicaid examiners. It is your right to obtain independent counsel to answer a question about a legal matter.

Will the Summit Case Manager actually go to the bank and search for documents?

YES. Any required document that you do not have easy access to we will obtain.

Do I need to attend the Medicaid interview appointment?

NO, the Summit Case Manager will represent your loved one and attend the interview appointment so you don’t have to.

What if the application is rejected?

The overwhelming percentage of applications submitted by Summit is approved on a timely basis. Generally, applications are not "denied" in a traditional sense. Medicaid may request additional information, question transfers or the use of a trust. They may also levy a sanction because of an “uncompensated transfer” resulting in a delay in the start date of Medicaid coverage. These matters are brought to your attention prior to submitting the application or immediately upon notification by Medicaid. We will notify you of what rights you have and work with you and/or your attorney to obtain eligibility if Medicaid is not satisfied with the additional information.

Will Summit go to an appeal if one is necessary?

Our personnel will attend an appeal hearing upon request. Depending on the reason for the denial, there may be an additional charge. However, we do not give legal advice and it is strongly recommended that you secure counsel. An appeal is the result of a rejection generally based on transfers, incomplete information, and/or the use of trusts.

What if the patient dies before the application is approved?

Generally, the flat fee is non-refundable. However, Summit will review the circumstances and may make an appropriate adjustment.

How do I get started?

Call us toll free at (866) 404-7427.

What if I have an attorney?

Summit will work with your attorney in the proccessing of the Medicaid application only. We do not do estate planning or give legal advice.

	You were very pleasant and extended yourself beyond the call of duty. Very receptive, helpful and appreciated. All office personnel very pleasant – keep it going!!
Carmen Billups Applicant's daughter