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Medicaid Eligibility:
Eligibility to receive
Medicaid waiver services from the Agency for Persons with Disabilities (APD)
is determined by
1) criteria established by APD (Florida Statutes 393) and
2) criteria established by Medicaid. Medicaid eligibility must meet
financial and disability requirements.
Most individuals applying for APD
services receive either Social Security Disability Income (SSDI),
Supplemental Security Income (SSI), or Social Security (SSA) (http://best.ssa.gov).
The APD application for services must be completed, and eligibility for
the program must be determined within 45 days for children and 60 days for
adults. This APD application includes determining eligibility for APD
services and eligibility for APD waiver services. These are two different
criteria.
Enrollment for APD Waiver Services
Enrollment to waiver services is
offered when the agency has available funds. Individuals on the waiver
enrollment wait list will receive a letter that offers them waiver
enrollment when it is available. All individuals offered waiver enrollment
must be eligible to receive Medicaid. If the individual does not have
Medicaid, the individual must complete the Medicaid eligibility process
before waiver enrollment can be completed. Children under 18, whose
parents do not fit the income requirements for Medicaid, may apply for APD
waiver service enrollment and be placed on the APD waiver services wait
list. When APD funding becomes available for their application for waiver
services, the child may apply for Medicaid as a "family of one" to become
eligible.
The Department of Children and Families, Economic
Self-Sufficiency coordinates with APD on eligibility determination for
Medicaid. Medicaid eligibility determination can take up to 90 days,
depending on the complexity of the situation. In some cases, eligibility
determinations must be made by the Social Security office and may take
additional time.
If funding becomes available and an individual has been
offered waiver services by APD, upon receipt of Medicaid eligibility
determination, APD will enroll the individual on the appropriate waiver
and transfer the file to a Waiver Support Coordinator (WSC) who is
selected by the individual or family to assist in establishing goals and
selecting services.
It is very important that the individual or family
provide the Economic Self-Sufficiency office with information to make
Medicaid determination in a timely manner. Even though an individual has
received a letter offering waiver services from APD, eligibility
determination for Medicaid requirements must first be met before the
individual can select a Waiver Support Coordinator to determine the needs
of the individual.
Available Services Your Child May Receive
(published by CARD)
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