Florida Medicaid Waiver Application - Click here to submit information in Spanish. |: Click on the link and listen to information about Yo nan Kreyol.
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Florida Medicaid Waiver Application
This video is a summary of Florida's Long-Term Care Medicaid Waiver Advocate's Guide, published on the Florida Health Justice Project website.
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An overview of the purpose of the video, an outline of general topics to be discussed, an update on the Medicaid HCBS program, and a description of relevant resources and tools.
Details about the first call to inquire about the program, the types of test and assessment questions asked during the call, and the next steps after the call.
A description of the waiting list release procedures and protocols, as well as the clinical and financial requirements for compliance with the Program.
Tips for choosing a plan, options available to Miami-Dade County, and steps to change your Managed Care Organization.
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A description of the types of plan services, features included in the care plan, and a list of guaranteed rights.
The importance of sharing your experience of running the system and your thoughts about the services offered by the Program THIS WEEK. Free webinars on housing and Medicaid programs. REGISTER NOW THIS WEEK. Free online courses on estate planning and Medicaid planning. REGISTER HERE!
Florida's Medicaid waiver program, where Medicaid recipients receive Medicaid long-term care services at home, or ALF, is actually a service provided by the Statewide Medicaid Managed Care Long-Term Care program (SMMC-LTC).
Home and community based (ALF) Florida medicaid programs have a waiting list, and if you are interested in Medicaid services that are not for the elderly, you should get on this waiting list as soon as possible (home Medicaid, Florida, no waiting list).
Difference Between Florida Medicaid Long Term Care Programs
Call your local Agency on Aging (AAA). These agencies are also called aging and disability resource centers (ADRCs). In Miami this agency is called the Alliance on Aging in Broward the agency is called the Aging and Disability Resource Center of Broward County. Each county in Florida is assigned an Area Agency on Aging (here is a list of Area Agencies. Your elder law attorney can do this.
AAA will provide some background information over the phone and give you an estimated time for the phone inspection.
Take a phone test. For example, in Miami-Dade, the phone test will take place "in a few weeks" - they did not give an exact date and time. I recommend editing their phone numbers so you don't accidentally send a call to voicemail. We usually recommend that someone other than the current Medicaid waiver applicant (if possible) answer the questions.
The goal of the phone screening is to get an initial idea of the type of care the person needs. This is not the time to brag or downplay the help a Medicaid applicant ultimately needs. Placement on the Medicaid waiting list is first-come, first-served. Instead, the more care a person needs, the higher up the waiting list they will be.
Managed Medical Assistance (mma)
Placement on the Medicaid waiver waiting list is determined through a review process on a first-come, first-served basis. Our law firm spends a lot of time with our clients analyzing the real questions that will be asked and teaching them how to answer them truthfully, but in a way that is beneficial to our client. Medicaid.
Interestingly, you don't need to apply for Medicaid now, so you don't need to have assets or income to qualify for Medicaid.
However, this wait provides a good opportunity to contact a Medicaid planning attorney to provide the necessary strategies to become Medicaid compliant.
If a person's condition worsens while you wait, you may request a new evaluation to move up the Medicaid waiting list.
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Soon after your first phone call, you'll receive a letter from your local agency on aging (in Miami-Dade, it's the Alliance on Aging; in Broward County, it's the Center on Aging and Disabilities, ADRC) saying something very similar. to the following:
Thank you for contacting the Area Agency on Aging Helpline. Our records show that [Medicaid Applicant] has been evaluated by our agency for long-term care services and has been placed on the Priority List(s) for appropriate programs that meet their requirements and what they appear to deserve. : The basic analysis takes into account the amount of aid needed, the amount of aid available and other factors. All customers are asked the same questions to create a priority waiting list. If funding is available, you will be contacted and assisted with all eligibility steps. You may need to submit a Medical Certification Form 5000-3008 with the DCF application to investigate Medicaid eligibility.
Remember, an experienced elder care attorney can help you reduce the time you spend on the waiting list and provide detailed instructions on how to answer questions during the vetting process. Medicaid.
Once your name is removed from the waiting list, the Medicaid applicant will be assigned to a Medicaid benefits counselor who will coordinate the CARES home visit. You must also ask your doctor to sign Form 3008 (valid for one year) to certify that you need long-term care services.
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This is also the time for you or your Medicaid advocate to submit your Medicaid application to DCF through their online ACCESS portal. Your AAA caseworker can also help you with the actual claim.
After you submit your Medicaid application and are accepted, you will be asked to choose a Medicaid managed care plan in your area with the help of a Choice Counselor at 877-711-3662.
Within five business days of choosing a managed care plan, the plan manager will schedule a service review visit and come up with a Care Plan to prevent as long a nursing home stay as possible. Anyone you choose can attend the care planning meeting.
Case managers can often authorize a limited number of direct care services. If you need other services, including any "doctor" services such as caregiver (nursing) care, ask the case manager if you need a prescription and tell the case manager that I would like to refer your request to the senior management of the managed entity. care plan. Also request a denial notice if your application is not approved.
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A special word about treatment methods. A long-term waiver will provide physical, occupational, speech, or respiratory therapy for maintenance, not just "improvement," for a minimum approval period of 6 months.
You have the right to challenge the denial, reduction or termination of services or any failure to provide services with reasonable promptness. The first step to the challenge is accessing your interior appeal and design. If it's denied, you can request a fair hearing from the Health Care Agency (AHCA).
If services are reduced or terminated, you may request that your services continue pending an appeal or fair hearing. However, you must request this in writing within 10 days of notification.
You also have the right to request your entire file for free, including information that plan staff took when they met with you or your providers and anything the plan used to make its decision.
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Any Medicaid recipient or authorized representative can file a complaint with AHCA about problems with a Medicaid managed care program, including problems getting authorization for care or services, missed services, or inability to find donors. You can call 1-877-254-1055 or file a complaint online here.
*Part of this article was written by my colleague Nancy E. By Wright, Esq - newright.law@gmail.com practicing in Gainesville, Florida on 12-15-2018 and copied with his consent to race.
Jason is committed to helping and protecting the most vulnerable members of society through his extensive legal work with the elderly.
All information on this site is provided for general information purposes only and may not reflect the applicable law in your jurisdiction. None of the information contained in this post should be considered legal advice, nor is it intended to take the place of legal counsel in any matter. No reader of this post should act or refrain from relying on any information contained or available on this website without first hiring an attorney. A licensed attorney in your state to discuss specifics and circumstances. Medicaid Issues Webcast & Audio Conference Hosted by Winter Park Health Foundation September 21, 2005 Topic: Florida's Medicaid Waiver Application Presenter: Joan Alker Senior Researcher Georgetown Center for Children and Families
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A Section 1115 proclamation is a request to the federal government to "repeal" certain sections of federal law. Medicaid has a wide variety of exceptions In exchange for this flexibility, states must agree to a budget neutrality agreement, where the federal government limits its financial influence.
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