Hello Jennalee76,
Medicaid is a process!! The application process varies from state to state but essentially it's the same based on family size, yearly income (Federal Poverty Level Guidelines). Google Federal Poverty Guidelines, 2023 or request the chart from your state's Medicaid office.
After Medicaid's systems' calculate income if it's over the guideline you will be denied. There are state programs that allow for a higher income levels. Under Home & Community-Based Services 1915(c) (see medicaid.gov) there are programs like Aging Services Access Point (ASAP) or Senior Care Organization (SCO, Frail Elder Waiver (FEW) that may help you qualify for Medicaid. There is an application process for these services as well based on age, disability, etc.
Once you are denied for over-income the game begins...there is a deductible, or spend down which allows you to submit health/medical related bills within a specific timeframe (i.e. 6 months) to meet the deductible and be approved for Medicaid. The determined deductible is another systems' calculation and it may be something like $2k monthly, which you can submit medical/health related bills/invoices which you had to pay and are NOT covered by any insurance (Out-of-Pocket with no reimbursement). Note that in-home caregiver (PCA) services is considered a medical/health related expense, but you need to know the requirements for meeting deductibles and adhered to them (Medicaid office can provide this information).
Once you receive the denial you may appeal the decision, design your questions for more insight on the procedures, but you can only appeal for specific reasons grounded in state laws governing administrative procedures for application process, etc. Example if Medicaid has 4 weeks to respond to application/request information and it took longer or the office/agent did not respond to a specific question, or the office/agent provided inaccurate information, etc. You may have grounds for an appeal.
*****In you need help with the application process or completion there are community agencies/counselors that may help or at least provide information. Start with your state's or town's elder services for referral.
*****If over income, expect the denial and pay attention to what is supposed to happen next (spend down, or deductible). This may seems difficult but asking specific questions related to meeting the deductible and reading, reading, reading will be helpful
***** It's a process the first step approved/denial is easiest, then you transition to the next step which is meeting the deductible and following the procedures for remaining on Medicaid
***** Search local elder services agencies, independent living agencies, Medicaid.gov and your state's website (i.e. Georgia.gov, Maine.gov, RI.gov...)
This is just an overview and based on my experience. I hope its helpful. Take care
