Medicaid is a health insurance program for low-income clients that is funded by federal and state governments and operated by states. People who are 65 and over may qualify for Medicaid coverage in Kentucky, provided they meet other requirements, including an income limit that varies depending on the sources of income. Medicaid covers inpatient and outpatient medical services, long-term residential care, in-home health and mental health services, hospice care, prescription drugs and other health-related costs.
Instructions
1. Fill a manila folder with the supporting documentation you'll need for your Medicaid application, including state-issued identification card, driver's license or other identification, birth certificate or other proof of citizenship or legal residency, health insurance policies and cards and proof of income--from employment, child support, Social Security or Supplemental Security Income benefits and pensions--for all members of your household.
2. Go to your local Kentucky Cabinet for Health and Family Services (CHFS) office and fill out an application for Medicaid. The application asks for general information such as your full name and address, as well as all income and other resources. Use the search feature on the cabinet's website to find the office nearest you (see Resources). If you are unable to apply in person, contact your local office to ask about other arrangements. No online application was available as of May 2010.
3. Ask whether you require a "spenddown," which is basically a monthly deductible that must be met before Medicaid coverage begins. If you have wages or other earned income, you may qualify for Medicaid Works--a Medicaid program for people who are employed--and may not have to pay a spenddown.
4. Write and mail or deliver an appeal letter to your local CHFS office if you are denied Medicaid after your application is reviewed. You should receive a response regarding your initial application within 45 days of your application date. Your appeal letter must be submitted within the time frame stated in your denial letter--typically 10 days--and must include your full name, date of birth and Social Security or Medicaid case number. The letter should state that you are "requesting an appeal" and explain why, and must specifically reference the denial letter.
5. Attend your appeal hearing, bringing all supporting documentation. This will vary depending on the reason for denial, but may include proof of income and medical records. Submit your documentation to the administrative law judge. You will receive a response within 90 days of this hearing. If you are denied after the appeal hearing, you may file a civil lawsuit against CHFS. CHFS does not assist with this process, but recommends that you consult with a lawyer if you are considering this.
Tags: your local, appeal hearing, appeal letter, CHFS office, full name, health insurance, Medicaid application
