Waiting may well be the
hardest part in applying for Medicaid. With millions of applications flooding
agencies' desks, many are stuck in limbo, delaying adequate care in some cases.
Prolonged waiting time also affects the operations of medical providers,
particularly in the financial department. The answer to this dilemma could be presumptive
eligibility (PE).
As the term implies, PE provides
an uninsured patient Medicaid benefits even before he gets officially
qualified, as long as his basic information checks out. In return, the patient
receives part of the Medicaid package and only gets the rest upon providing
additional data. In the meantime, the medical facility can get paid through
Medicaid benefits.
If the patient files for
a full application within a month of PE determination, the PE will last for as
long as a thorough Medicaid assessment takes. Patients ineligible for Medicaid,
as determined in the PE process, may be referred by the hospital to a single,
streamlined application (SSA). Meanwhile, those who were determined to be
eligible for Medicaid during the PE process may also be referred to the single,
streamlined application (SSA), if they were eventually found to be ineligible,
or wish to apply for coverage through the health insurance marketplace,
instead.
The SSA integrates various
forms used by federal health programs several years ago. The application is
designed like a questionnaire, which helps make choices much clearer for the
applicant. It's also arranged in step-by-step segments so that applicants can
be guided properly.
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