Medicaid is in a constant state of flux – especially as lawmakers continue to tangle with the repercussions of expansion. The legislative study group focused on long term care wants to assess the process for applicants in South Dakota.
How to apply for Medicaid, the processing time for applications, and what happens as an application pends was in front of the state study committee on sustainable models for long term care in its meeting Thursday.
Many people rely on Medicaid to cover the cost of staying in a nursing home.
Sam Masten is an administrator for the Department of Social Services division of economic assistance. He explained the reality of the application process.
“Take a quick look at what these forms look like," Matsen said. "So, this is the application for resource assessment, long term care, and other related medical assistance. It is an 18-page long application with 12 pages of actual questions related to their eligibility. The other application one might encounter is this application for health coverage and help paying costs. It is 25-pages long and contains 14 pages of actual questions related to eligibility.”
Matsen said applicants are required to hear back within 90 days on a disability determination, and 45 days for other claims. However, applicants missing pieces of information can further drive wait times.
Rep. Linda Duba asked Matson about the clarity of the paperwork.
“We have tried different things throughout the years – we tried icons around it, I remember the last one even had a big stop sign to try to draw attention to it," Matson said. "We’re always trying and talking to our benefits specialists about what types of things they don’t see back and trying to find ways to improve that. Because that’s exactly it – that’s what drives up processing time.”
Board chair Jean Hunhoff wanted to know how South Dakota compared.
Hunhoff: “Is South Dakota’s application form more or less than the surrounding states?”
Matsen: “It varies. I saw Minnesota’s long term care application is around 25 pages, Iowa is around 29, then if you went to Nebraska, it was more around 12 or so. I don’t think the content of these applications is different. It is largely the way the questions are being asked that is determining the page length.”
No formal actions have been taken, and the board will report its recommendations to state leadership this autumn. The next meeting of the board is Sept. 25.