Our planning services may include:

• Medicaid eligibility evaluations

• Income and resource analysis

• Nursing home Medicaid planning

• Home and Community-Based Services (HCBS) planning

• Spend-down planning and strategies

• Asset conversion strategies

• Exempt resource planning

• Spousal impoverishment planning

• Community spouse resource protections

• Review of property and other significant assets

• Review of prior transfers and potential eligibility concerns

• Guidance before assets are sold, transferred, gifted, or spent

• Timing and application strategy

• Medicaid-compliant planning options

• Coordination with elder law attorneys and other professionals when appropriate

The goal is not simply to spend until you qualify. It is to understand your options and develop the right Medicaid strategy before important financial decisions are made.

Medicaid Applications

A successful Medicaid application involves much more than completing a form. We manage the application process from preparation through determination, helping identify potential eligibility issues before they become problems.

Our application services may include:

• Pre-application eligibility review

• Income and resource verification

• Document collection and organization

• Medicaid application preparation

• Application submission

• Authorized Representative services

• Communication with Indiana FSSA/DFR

• Responses to requests for additional information

• Asset Verification System (AVS) follow-up

• Interview preparation and assistance

• Follow-up on pending applications

• Resolution of outstanding verification issues

• Monitoring application progress

• Review of notices and eligibility determinations

• Coordination with nursing facilities and other professionals when appropriate

We don't simply submit an application and wait. We remain involved throughout the process, addressing issues as they arise and working toward a successful Medicaid determination.

Miller Trust (Qualified Income Trust) Assistance

When an individual's income exceeds the applicable Medicaid income limit, a Miller Trust—also known as a Qualified Income Trust (QIT)—may allow the individual to establish financial eligibility for long-term care Medicaid.

We assist with:

• Reviewing income to determine whether a Miller Trust may be needed

• Explaining how a Miller Trust works

• Preparing the required Miller Trust documents

• Coordinating establishment of the trust

• Guidance on opening the trust bank account

• Explaining monthly funding requirements

• Identifying which income must be deposited into the trust

• Guidance regarding proper use of trust funds

• Coordination with Medicaid during the eligibility process

• Ongoing guidance regarding trust administration

• Troubleshooting Miller Trust funding or eligibility issues

A Miller Trust is not a way to hide or give away income. It is a Medicaid planning tool that must be established, funded, and administered correctly to accomplish its intended purpose.

Miller Trust (Qualified Income Trust) Assistance

When an individual's income exceeds the applicable Medicaid income limit, a Miller Trust—also known as a Qualified Income Trust (QIT)—may allow the individual to establish financial eligibility for long-term care Medicaid.

We assist with:

• Reviewing income to determine whether a Miller Trust may be needed

• Explaining how a Miller Trust works

• Preparing the required Miller Trust documents

• Coordinating establishment of the trust

• Guidance on opening the trust bank account

• Explaining monthly funding requirements

• Identifying which income must be deposited into the trust

• Guidance regarding proper use of trust funds

• Coordination with Medicaid during the eligibility process

• Ongoing guidance regarding trust administration

• Troubleshooting Miller Trust funding or eligibility issues

A Miller Trust is not a way to hide or give away income. It is a Medicaid planning tool that must be established, funded, and administered correctly to accomplish its intended purpose.

Medicaid Denials, Fair Hearings & Appeals

A Medicaid denial or adverse action does not necessarily mean the decision is correct—or that the case is over. We review what happened, identify the underlying issue, and help determine the appropriate next step.

We assist with:

• Review of Medicaid denial and adverse-action notices

• Identification of the reason for denial

• Review of eligibility and case history

• Identification of processing or eligibility errors

• Review of income, resource, and transfer issues

• Preparation and filing of Fair Hearing requests

• Requests for continuation or reinstatement of benefits when applicable

• Collection and organization of supporting documentation

• Preparation of exhibits and supporting evidence

• Communication with Indiana FSSA/DFR and other involved agencies

• Resolution efforts before the hearing

• Fair Hearing preparation

• Assistance throughout the administrative appeal process

• Representation at Fair Hearings when permitted

• Follow-up after appeal decisions

A denial deserves a careful review. We look beyond the notice to determine what happened, what the Medicaid rules require, and what can be done to move the case forward.

Medicaid Advocacy & Complex Case Resolution

Some Medicaid cases don't fit neatly into an application or annual review. When a case becomes delayed, complicated, or simply seems stuck, we work to identify the problem and advocate for resolution.

We assist with:

• Eligibility disputes and complex eligibility issues

• Delayed or unresolved Medicaid cases

• Income and resource questions

• Transfer-of-asset concerns

• Asset Verification System (AVS) issues

• Missing or unprocessed documentation

• Coverage interruptions and suspensions

• Medicaid reinstatement issues

• Patient liability questions and discrepancies

• Institutional-to-community transitions

• Nursing home and HCBS Medicaid issues

• Medicaid policy research and interpretation

• Review of conflicting or incorrect Medicaid information

• Communication and follow-up with Indiana FSSA/DFR

• Coordination with nursing facilities, hospitals, managed care organizations, case managers, and Medicaid contractors

• Escalation of unresolved issues when appropriate

• Difficult or unusual Medicaid circumstances

When something doesn't look right, we keep asking questions. Our role is to understand what happened, identify the applicable Medicaid rules, and remain persistent in working toward a resolution.

Medical Bills, Claims & Coverage Problems

Medicaid eligibility and billing don't always line up as they should. A coverage issue, delayed eligibility determination, incorrect effective date, or claim problem can leave families facing bills they may not actually owe.

We assist with:

• Outstanding medical and nursing facility bills

• Medicaid-related billing questions

• Medicaid claim denials

• Coverage and effective-date issues

• Retroactive Medicaid eligibility issues

• Bills incurred while Medicaid eligibility was pending

• Medicaid coverage gaps and interruptions

• Patient liability discrepancies

• Incorrect or unexpected charges

• Medicaid recoupment notices

• Overpayment claims

• Review of Medicaid eligibility related to disputed bills

• Coordination with nursing facilities and healthcare providers

• Communication with Indiana Medicaid when eligibility affects billing

• Review of notices, claims information, and supporting documentation

Before paying a questionable bill or assuming Medicaid will not cover it, we help determine what happened, whether eligibility or coverage is involved, and what steps may be available to resolve the issue.

Family Education & Consultation

Sometimes you don't need someone to manage the entire Medicaid case—you need someone who understands Indiana Medicaid to explain the rules, answer your questions, and help you determine what to do next.

Our consultation and education services may include:

• Medicaid eligibility questions

• Income and resource rules

• Nursing home Medicaid requirements

• Home and Community-Based Services (HCBS) options

• Spousal Medicaid and community spouse rules

• Review of your current financial situation

• Discussion of potential eligibility concerns

• Explanation of Medicaid notices and requests

• Spend-down and planning considerations

• Questions about property, vehicles, and other assets

• Transfer and five-year lookback concerns

• Guidance before making significant financial decisions

• Review of available options

• Identification of issues that may require an elder law attorney or other professional

• Development of recommended next steps

You don't have to become a Medicaid expert to make an informed decision. We help you understand the rules that apply to your situation, your available options, and what should happen next.

We can help families or individuals get answers or assistance with issues they may be facing. Sometimes, just having a friend in your corner provides the comfort and confidence needed to ease the stress that comes with an illness, injury, or facility placement.