Free Public Help: State Medicaid Offices and Other Public Agencies

Every state has a public agency that runs its Medicaid program and decides who qualifies. In many states, applications are handled by county or regional offices; in others, by a central processing center. Alongside the Medicaid agency, a network of other public programs can help older adults and families understand their options at no cost. This guide explains who does what, what kind of help to expect from each, and how to get the most from free public help. For the agency and application route in each state, see the state agency directory and the state guides.

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

The state Medicaid agency

Each state designates a single state agency to run Medicaid. Its name varies: a Department of Health, Department of Human Services, Health Care Authority, Department of Social Services, or a separate Medicaid agency. In some states, one agency sets policy and another (or county offices) decides individual applications.

What the Medicaid agency does

Accepts and decides applications for Long-Term Care Medicaid, including nursing home and waiver coverage.
Sends verification requests and decision notices.
Calculates the patient liability and spousal allowances.
Handles renewals and change reports.
Provides the forms and the rules (often in a public eligibility manual).
Must help applicants who need assistance completing the application, including people with disabilities and people with limited English.

What it does not do

It does not give advice on how to plan, protect assets or structure transfers.
It does not represent the applicant’s interests; its job is to apply the rules.

How to get help from the agency

Ask for help completing the application. Federal rules require states to assist applicants.
Ask for an interpreter or accommodation if needed. These are free.
Ask for the eligibility manual section that applies to a question you have. Many states publish their manuals online.
Ask for decisions in writing, especially if a caseworker tells you something by phone that affects a decision.

See Working with your caseworker.

County and local offices

In many states, applications for Long-Term Care Medicaid are handled by county departments of social services, human services or job and family services, or by regional offices. Local offices often accept applications in person, and caseworkers there may know local nursing homes and programs well. Where a state uses central processing, local offices may still help with forms.

Area Agencies on Aging and Aging and Disability Resource Centers

Area Agencies on Aging (AAAs) serve older adults in every part of the country. They provide information about local services, some of which are paid for by federal Older Americans Act funds rather than Medicaid: home-delivered meals, caregiver support, transportation and more. In many states, AAAs also run waiver assessments or case management.

Aging and Disability Resource Centers (ADRCs) are “one-stop” information and referral points, often run by or with AAAs. In some states, the ADRC is the front door for Long-Term Care Medicaid waiver programs, including screening and waiting-list placement.

What they do well: explain local options, help with assessments and waiting lists, connect families to services. What they generally do not do: planning advice or representation in appeals.

The free Medicare counseling program (SHIP)

Every state has a State Health Insurance Assistance Program (SHIP), sometimes known by a state-specific name, that provides free, unbiased counseling about Medicare, Medicare Advantage, Part D, Medigap and related programs such as Medicare Savings Programs and Extra Help. SHIP counselors can explain how Medicare and Medicaid work together and help with some paperwork. They do not sell insurance.

The long-term care ombudsman program

Every state has a long-term care ombudsman program that advocates for residents of nursing homes, assisted living and similar facilities. Ombudsmen help with complaints about care, rights, discharges and evictions, and they work for the resident. Their help is free and confidential. They are especially useful when a facility threatens discharge during a Medicaid pending period. See Nursing home discharges and evictions.

Adult Protective Services

Adult Protective Services (APS) investigates reports of abuse, neglect, self-neglect and financial exploitation of older and vulnerable adults. If you suspect someone is taking an older adult’s money or property, or an older adult is unsafe at home, APS is the public agency to report to. APS involvement can also matter for Medicaid: financial exploitation may explain transfers in the look-back period and support a hardship waiver.

The state insurance department

The state insurance department regulates insurance companies and agents, including those selling long-term care insurance, annuities and Medicare supplement policies. It can take complaints about sales practices, such as an annuity sold with misleading claims about Medicaid or VA benefits.

Veterans service officers

Accredited veterans service officers at county veterans offices and veterans service organizations help veterans and surviving spouses apply for VA benefits at no cost. See the Veterans hub.

Free legal aid

Legal aid programs provide free legal help to people with low income, often including help with Medicaid denials and fair hearings. Many also have senior legal services programs funded for adults 60 and older. See How free legal aid works.

Comparing free public help

Source	Best for	Limits
State Medicaid agency	Applying, forms, status, decisions	Does not give planning advice
County or regional office	In-person help with applications	Varies by office
Area Agency on Aging / ADRC	Local services, waiver screening and waiting lists	Not legal or planning advice
SHIP	Medicare and Medicare-Medicaid questions	Not long-term care planning
Long-term care ombudsman	Residents’ rights, discharges, complaints	Does not handle eligibility planning
Adult Protective Services	Abuse, neglect, financial exploitation	Investigative, not advisory
State insurance department	Complaints about insurance and annuity sales	Does not give individual advice
Legal aid	Denials, hearings, some planning for low-income clients	Income limits; capacity limits
Veterans service officers	VA claims	VA only

Making the most of free help

Be specific. “My mother is in a nursing home in our county, has $14,000 in savings and a house, and my father lives at home. What forms do we need?” gets a better answer than “How does Medicaid work?”
Write down answers, with the date and the person’s name.
Ask where the rule comes from. If an answer seems wrong, ask for the manual section.
Use more than one source. The ombudsman for rights, the agency for forms, SHIP for Medicare.
Know the limits. Free public help is valuable, but it is not planning advice.

A worked example

Lorraine’s father has early dementia and lives alone. She is not sure whether he needs assisted living, home care or a nursing home, or how to pay for any of them. She starts with the local Area Agency on Aging, which explains the state’s waiver program for older adults, puts him on the waiting list and arranges an assessment. The AAA also tells her about home-delivered meals funded by the Older Americans Act, which start right away. She calls the free Medicare counseling program (SHIP) to review his Medicare Part D plan and learns he may qualify for help with prescription costs. When she files his Medicaid application at the county office, the caseworker helps her complete the long-term care section. Later, when the assisted living residence he moves into gives a 30-day notice, she calls the long-term care ombudsman, who helps resolve the dispute. Each public program handled a different part of the problem, and none charged a fee.

What to bring when you contact a public agency

The person’s full name, date of birth, address and Medicare number.
A short summary of their care needs and current living situation.
A rough list of income and assets.
Any notices received, with dates.
Written authorization if you are acting for the person.
Your questions, written down in advance.

Language access and accommodations

Medicaid agencies and many other public programs must provide free interpreter services and translated materials for people with limited English, and reasonable accommodations for people with disabilities, such as help completing forms, large-print notices or alternative ways to communicate. Ask for what you need when you first contact the office, and ask again in writing if it is not provided.

Getting experienced help

Free public help is the right starting point for most families. When the situation includes a spouse at home, gifts, a home, a trust, income over the cap or a denial, planning advice matters, and public agencies generally cannot provide it. A Certified Medicaid Planner can provide that advice. As a rough guide, published fees for help with an application range from about $500 to $6,000, full planning from about $2,500 to $15,000 or more, and hourly help from about $150 to $600. See Questions to ask before paying anyone for help.

Frequently asked questions

Can the Medicaid caseworker tell me how to protect my assets? Generally no. Caseworkers apply the rules but do not give planning advice.

Is the Area Agency on Aging part of Medicaid? Not exactly. AAAs are part of the national aging services network. In many states, they also help run Medicaid waiver programs.

Does the ombudsman help with Medicaid applications? Ombudsmen focus on residents’ rights. They can help if a facility is pressuring a resident about payment or threatening discharge.

Is the SHIP the same as Medicaid? No. SHIP is a free counseling program focused on Medicare.

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