How long does approval take?

How long does approval take?

Short answer: States must generally decide within 45 days (90 if a disability decision is needed). Long-term care applications often take two to four months because of verification.

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

Federal rules set the outer limits: 45 days for most applications and 90 days for those that depend on a disability determination. In practice, Long-Term Care Medicaid applications often take longer because the state must verify assets and review the five-year look-back.

Typical range: a simple application may be decided in a few weeks; many take two to four months; complex cases with a spouse, a home, trusts or past gifts can take longer.

To speed things up:

  • file a complete application;
  • send documents up front;
  • respond to every verification request on time;
  • explain large withdrawals with receipts.

If a decision is overdue and you have sent everything requested, ask in writing for a status update, ask for a supervisor, and consider requesting a fair hearing on the delay.

Getting help

Every situation is different, and small facts can change the answer. If this question affects a real decision, especially with a spouse at home, a home, gifts or a trust, a Certified Medicaid Planner can apply your state’s rules to your situation. As a rough guide, published fees for help with an application range from about $500 to $6,000, and hourly help from about $150 to $600.

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

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