How to Qualify for Nursing Home Medicaid Benefits in Indiana

Sometimes elderly or disabled individuals may need to move to a nursing facility, where someone is available to help them with their daily care and medical needs 24 hours a day. Although Indiana Medicaid will pay for qualifying individuals to stay in a nursing facility, two requirements must be met. First, the individual must qualify for Indiana Medicaid, which may include financial requirements. Second, the individual must be determined in need of nursing facility care.

Things You'll Need

• Application for Medicaid
• Long-Term Care Services Application form
• Physician Certification for Long-Term Care Services form
• PASRR Level I form
• Envelope
• Stamp

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Instructions

• 1

  Apply for traditional Indiana Medicaid. This program is open to both elderly and disabled Indiana residents. Elderly applicants must be at least 65 years old, and be eligible to receive Social Security Income (SSI) or have an income less than $553 per month if single or less than $830 per month if married. Those who are not eligible for SSI must also have resources no greater than $1,500 if single or $2,250 if married. These income and resource guidelines were applicable as of the year 2010. The requirement for disabled applicants is an impairment or disease that has lasted at least four years that renders them unable to engage in useful occupation.

• 2

  Begin the Pre-Admission Screening (PAS) process by filling out three forms: the Long-Term Care Services Application form, the Physician Certification for Long-Term Care Services form, and the PASRR Level I form. The Physician Certification for Long-Term Care Services form must be completed by a doctor, and it is preferable (but not required) that the PASRR Level I form is completed by a doctor, too.

• 3

  Mail all three forms to:

  Aging and Community Services

  1531 15th St., Ste. G900

  Columbus, Indiana 47201-1302

  An Aging and Community Services representative will call you to schedule an interview.

• 4

  Attend the scheduled interview, bringing with you any documents or forms you were asked to bring. Answer all questions completely and truthfully. After your interview, your case is reviewed to determine if nursing home placement is the best option for your situation, or if you would be better served at home or by community-based services, such as an assisted living facility or adult day care center.

• 5

  Wait to hear the results from your PAS. If you stay in a nursing facility even though the PAS determined that was not the best option, Medicaid will not pay for your first year of services at the facility.