Red tape for Medicare or Medicaid often hurdles for applicants

Want to cut through the red tape in applying for health care benefits under Medicare or Medicaid?

Good luck.

Medicare provides health care benefits for those 65 or older or those with a disability. Medicaid provides health care benefits for adults and children with low income and limited resources. For those who are computer-savvy and have patience, applying online for Medicare or Medicaid is the simplest method: socialsecurity.gov for Medicare and dwss.nv.gov for Medicaid.

Online, applicants can find eligibility and benefit information and lists of the documentation to have on hand before completing an application. The time to complete an application is about 45 minutes.

After an online application is submitted, follow-up phone calls may be made to the applicant, but when everything is in order, Medicare or Medicaid health care identification cards are issued, typically within 45 days of an online application.

But it’s not always that easy.

Talk to Las Vegan Elaine Coomer, whose cerebral palsy has sent her to Social Security and Medicaid offices many times. Her recommendation is that, because each individual has a different story, “Go directly to the appropriate office and do your business in person.” “A computer can’t answer your questions, but a knowledgeable case worker can,” she said. She also believes that when an application is completed with the help of a case worker, the information input is immediate, and delays are minimized. Coomer also arrives at the appropriate office before it opens to be among the first in line.

The advice of Glen Smith and Patrick Neales, who recently visited the Henderson Social Security office, was “bring a chair.” Smith and Neales arrived at the office at 7 a.m., two hours before the 9 a.m. opening time. Smith said he didn’t have his questions answered on the phone because “you use up all your minutes waiting for someone to answer.”

Medicare questions can be answered at three local Social Security offices. Medicaid questions can be answered at one of eight Nevada Division of Welfare and Administrative Services offices. A client checks in with a receptionist and states the reason for the visit at each office. The client’s name is then put on a list with other people having similar issues. Except for those first in line, the wait time most often is roughly two hours, though stories of 10-minute to six-hour waits are told.

Mondays are typically the busiest days of the week at either office. Tuesdays after a Monday holiday are also busy.

Questions can be answered via a phone call, but the phone lines are often busy or, if a call is answered, a hold is often involved. In some cases, a caller can leave a number for a call back, and those calls are typically returned within 20 to 30 minutes.

Need instant help to apply for Medicaid? The best help comes after being admitted to an area hospital without insurance and without assets to pay the bill. A hospital social worker will then offer to access help for the patient or the patient’s family in applying for any benefits that might be applicable. Some hospitals outsource Medicaid applications to a company specializing in such applications. The company has special relationships with Division of Welfare case workers, and their cases are handled promptly. If a Medicaid application is approved, it can be retroactive to the date of admission or even, upon request, up to three months prior to application. The hospital will then get reimbursement, and the patient has health care coverage at least for one year.