what type of lawyer do i need for retroactive medicaid in georgia

by Prof. Gerhard Champlin PhD 9 min read

The short and simple answer is no, a lawyer is not needed to get Medicaid. However, based on one’s marital status, financial holdings, and complexity of other relevant factors, it may be best to hire an attorney who specializes in Medicaid in the state in which one resides.

Full Answer

Does Georgia have retroactive Medicaid coverage for nursing homes?

Jul 13, 2010 · Feiler & Associates can assist with your Social Security claim, and educate your physician on what they can do to seek payment once you qualify. We obtain state compensation of millions of dollars a year for medical providers in this exact situation, improving the financial health of the provider, while securing payment for a patient's treatment.

Do all elder law attorneys provide Medicaid planning services?

NOTE: Services covered by Medicaid and NOT requiring Prior Authorization will be paid for approved retroactive months. Do not make a DCSS referral if Medicaid is approved for retroactive Medicaid only. Medicaid may be requested for the three prior months when adding an …

Can I get Medicaid retroactively in Florida?

Feb 28, 2022 · Retroactive Medicaid allows Medicaid applicants to receive nursing home coverage for up to 3 months prior to the date of one’s application. Stated differently, as long as one meets Medicaid’s eligibility requirements in the 3 months preceding application, Medicaid will still pay Medicaid covered expenses during that timeframe.

How do I apply for retroactive Medicaid and regular Medicaid?

Nov 28, 2011 · 21. Do I need to fill out the ownership and managing employees control information? 22. I own a Durable Medical Equipment (DME) company and I have applied to become a Georgia Medicaid provider. Is a site visit 23. Is it still a requirement to mail the original Power of Attorney for Payee (POA) to HPES?

How to get a replacement 147-C letter?

If you don’t have your 147-C letter, call the IRS Business Line at 1-800-829-4933 and request a replacement, provided you are authorized by the business to make the request. The IRS will mail the letter, which could take one to two weeks, or they can fax it to you. Be prepared to give the IRS representative the business’ EIN, as well as the business address and fax number if applicable. To expedite the enrollment process, request that the IRS fax you the letter. The IRS can send the letter via fax or mail it to an authorized representative of the business.

How to check if my HPEs license is suspended?

You can check your enrollment file status by visiting the MMIS website, www.mmis.georgia.gov. Click on the Provider Enrollment link, Contract Status link and key in the provider ID number. If your file is noted as suspended, mail a copy of the license and expiration date. You may also fax the copy of your license to HPES at 1-866-483-1044. These documents are available from the Georgia Composite Medical Board or Secretary of State websites at

Can a provider be denied Medicaid?

Providers who are on certain federal and state exclusionary lists, or who have some type of restriction on their professional license, are normally denied enrollment into the Medicaid program.

Can you fax POA?

The POA can now be faxed or uploaded through the Web Portal. The submitted POA must reflect the notary seal, and all signatures must be clearly seen when the form is faxed or scanned.

Can you take action on GBHC?

You will not be required to take any action. All providers who were enrolled under the GBHC program will have this contract or category of service automatically terminated from their enrollment files.

What is the role of a Medicaid attorney?

On the other hand, Medicaid attorneys often focus more on the legal aspects of Medicaid planning, such as creating Medicaid asset protection trusts or Qualified income trusts, which makes them the better option for this type of assistance.

What do elder law attorneys do?

What Elder Law Attorneys Do? Elder law attorneys, also called elder care attorneys, estate and trust attorneys, or Medicaid lawyers, assist persons in preparing for long-term care and death. They assist seniors in a large and diverse array of legal tasks, which encompasses retirement planning, estate planning, creating wills and durable power ...

How does Medicaid annuity work?

This strategy reduces one’s countable assets, while at the same time , protecting some of them for family. Essentially, Medicaid applicants gift approximately half of their “excess” assets (assets over Medicaid’s limit) to their loved ones and then purchase an annuity with the remaining “excess” assets. (An annuity turns countable assets ...

What is Medicaid asset protection trust?

One such strategy that elder law attorneys can implement is a Medicaid asset protection trust (MAPT). This type of trust not only prevents one from becoming ineligible for Medicaid due to gifting assets ...

How long does it take for Medicaid to pay for long term care?

Medicaid attorneys and specialists also assist with crisis planning, which occurs when a senior needs Medicaid benefits within 30-60 days.

What is a medicaid planner?

For persons who have Medicaid cases that are fairly simple and straightforward, a Medicaid planner, also called a Medicaid specialist or a Medicaid Advisor, might be a good option. Working with a professional Medicaid planner can be a lot more cost efficient than working with a Medicaid attorney.

How long does Medicaid look back?

The look back period is 5 years in all states except California (Medi-Cal has a 2.5 year look back).

How old do you have to be to get breast cancer in Georgia?

Under age 65. A Georgia resident and. A U.S. citizen or qualified alien. Any uninsured, low-income woman who has been diagnosed with breast or cervical cancer should go to the county health department in their county of residence. You may contact Public Health at 404-657-2700 for county health department locations.

What is income for medicaid?

Income is money that you get from working, or money that someone gives you, or checks that you receive, such as a Social Security check, or unemployment benefits. Whether your income level qualifies you or your family for Medicaid depends on the size of your family and the Medicaid program for which you are applying.

How long does RSM coverage last?

There are two types of coverage for RSM: RSM for pregnant women pays for medical care for pregnant women, including labor and delivery and for up to 60 days after pregnancy ends. Pregnant women who qualify are entitled to the full-range coverage of Medicaid services.

How old is a child when they get RSM?

RSM for children pays for medical care for children from birth through the last day of the month in which the child turns nineteen (19) years of age. These children may qualify at various income levels depending on age, family size and income.

What is TANF for a family?

If you are leaving Temporary Assistance for Needy Families (TANF) and need health coverage. If you are a family with children under 19 and have very low or no income. If your income is higher than the limits and you have medical bills you owe (and you are pregnant, under 18 or over 65, blind, or disabled.)

Can I see a doctor before I apply for medicaid?

Can I see a doctor before Medicaid eligibility is determined? You will be responsible for any bills, if you do not communicate with your doctor about your application for Medicaid. It will be the doctor’s decision to accept you as a Medicaid patient and file your claim (s) retroactively, if you become eligible.

Do you need nursing home care for a child?

Eligibility for children is based on the child's status, not the parent's. You need nursing home care. If you are leaving Temporary Assistance for Needy Families (TANF) and need health coverage. If you are a family with children under 19 and have very low or no income.

What is the Medicaid program in Georgia?

Georgia Medicaid members who are employed may be eligible for health insurance premium assistance through a Medicaid program called the Health Insurance Premium Payment Program (HIPP). This program provides coverage for Autism Spectrum Disorders (ASD) services for individuals under the age of 21.

What is P4HB in Georgia?

P4HB® fills a critical gap in health care for underinsured and uninsured women by expanding Medicaid eligibility to those who qualify for family planning services.

What is estate recovery?

Estate recovery is a program, required by federal law, whereby Medicaid members with qualified assets reimburse the taxpayers for long term care and home and community-based services provided through Medicaid. Funds are recovered from the member's estate, after death, for the cost of these services.

What is ASD insurance?

ASD coverage is provided for assessment and treatment services according to severity and is based on medical necessity. Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Eligible Parties: Children. In 2010, the Georgia Department of Community Health (DCH) implemented the country’s first CHIPRA Premium Assistance Program.

Why is Medicaid retroactive?

This program offers retroactive coverage, because applying for Medicaid with all your mental energy can be difficult. Trying to do this while sick or injured would make the process even harder. This is why Medicaid Retroactive Coverage will provide you an extended amount of time to apply for coverage.

Who determines if you qualify for retroactive coverage?

Whether you qualify for Medicaid Retroactive Coverage will be determined by your state’s Health and Human Services Commission. That being said a summary of how the process generally works is:

How long does it take for a medical bill to be covered by medicaid?

Medical bills can be covered under Medicaid Retroactive Coverage as long as the medical services occurred within the Medicaid retroactive period (generally past 3 months) and you qualify for Medicaid. The exact time frame will depend on your state’s Health and Human Services Commission though. Other medical bills that retroactive Medicaid may cover ...

How long can you have past due medical bills in Texas?

Medicaid’s Conditions To Receive Help With Past Due Medical Bills. In Texas you can have medical bills covered dating 3 months back. These are the conditions that must be met to receive help with hospital bills. You received medical services within the 3 month window that you applied for help. Provide your medical bills are unpaid or ...

What agency manages Medicaid?

Editor’s note: Health and Human Services Commission is the agency in your state that manages the Medicaid program. You can also apply for programs like SNAP ( food stamps ), WIC, and CHIP. Apply online through your state’s Health and Human Services Commission.

Is Texas in the lower half of Medicaid?

Each state has different qualifications, although Texas is in the lower half of Medicaid spending, quality, and eligibility therefore you should n’t be discouraged if you do not meet the criteria below. Children up to age 20 who live wit their parent/guardian. Pregnant women.