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Medicaid provides long-term care services for individuals in Nursing Facilities (NFs) and Intermediate Care Facilities for the mentally retarded (ICF-MRs).
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Home and Community-Based Services Waivers provide home health care to individuals who wish to stay in their home but otherwise need institutional care. The number of consumers that can be enrolled in a waiver program at any one time is limited.
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Income and resources will be evaluated by an Eligibility Referral Specialist
How do I apply?
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To apply for Medicaid for an individual going into or currently in a Nursing Facility, complete and submit the following application: click here or apply online
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If you do not have an open Medicaid case, you must complete and submit BOTH of the following applications to apply for Passport/Waiver services (click here -7200 form) (click here -2399 form) If you want someone to apply for you or on your behalf, please complete and submit the Designation of Authorized Representative form (click here)
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If you do have an open Medicaid case, complete and submit the following application to apply for Passport/Waiver services: (click here). If you want someone to apply for you or on your behalf, please complete and submit the Designation of Authorized Representative form (click here)
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In person at our agency during regular business hours (M – F 8:00 am-4:00 pm)
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By dropping a completed application in the agency drop box located in the front of our building, open 24 hours
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By mailing a completed application 239 W Main Street Lancaster, Ohio 43130
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By faxing a completed application to 740-689-4848
What verifications are needed?
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Proof of citizenship, or alien registration card/I-9
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Social Security Card
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Birth Certificate
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Driver’s License, State ID
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Proof of all income (employment, child support, disability, unemployment, etc)
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All resources (bank statements, all life insurance policies, stocks, bonds, annutities, IRA, and trusts)
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Proof of disability (doctor statement, doctor/hospital records)
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Social Security award letter (if applicable)
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Additional verifications may be requested or required
What happens after I submit my application?
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We offer face to face appointments for you or your Authorized Representative Monday – Friday from 8:00 am – 4:00 pm
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If you cannot come to an appointment during regular business hours, you can file an application at any time and we will contact you to make other arrangements