Applying for Long-Term Care Medicaid and Keeping Coverage

Getting Long-Term Care Medicaid is not a single form. It is a process that starts before the application is filed and continues for as long as the person receives care: gathering records, answering verification requests, waiting through the “Medicaid pending” period, handling a denial or a fair hearing if one comes, renewing coverage every year and reporting changes along the way. This section walks through each stage in plain language.

Figures change periodically. Double-check current amounts before relying on them.

The short version

• Applying is free. There is no charge to file an application with a state Medicaid agency.
• The filing date matters. It sets the start of the look-back period and can affect how many earlier months Medicaid will pay for.
• Most states must decide within 45 days, or 90 days when the application depends on a disability decision, but long-term care applications often take longer because of verification requests.
• A denial is not the end. You have the right to a fair hearing, and many denials are fixed simply by sending a missing document.
• Coverage must be renewed, usually once a year, and changes in income, assets or living arrangements must be reported.

Before and during the application

• How to apply, step by step
• Applying for nursing home Medicaid
• Applying for a waiver (home and community care)
• Application documents checklist
• How Medicaid verifies income and assets

Waiting for a decision

• Medicaid pending: what it means and what to do
• Retroactive coverage
• How long approval takes

If the answer is no

• Denied? What to do next
• Fair hearings and appeals

Keeping coverage

• Renewals (redeterminations)
• Applying in another state
• Moving to another state while on Medicaid

Where to start

If someone is already in a nursing home or about to be discharged from a hospital, start with Applying for nursing home Medicaid and Medicaid pending. If the goal is care at home or in assisted living, start with Applying for a waiver, because many waivers have waiting lists and getting on the list early matters. Every family should read the documents checklist before filing, and every state guide explains how applications are filed in that state.

Applications that involve a spouse at home, gifts in the past five years, a home, a trust or income over the state’s cap are where mistakes are most costly. For those situations, experienced help from a Certified Medicaid Planner is worth considering before the application is filed, not after a denial.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.