How I Got Denied (and then approved!) For Medicaid Home Aides

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Art: Robin Mead

Dianella applied for a home care through Medicaid and got denied. A few months later, she applied again and this time she got approved! What changed? Dianella was kind enough to share her story to help others.


Dianella Gets Approved For Medicaid Home Care

I was really, really struggling and trying to figure out how to continue on. I tried getting help through Medicaid, but was denied.

They denied me because they said I didn’t meet their “level of care” requirement. I don’t know why I didn’t meet it. I need help with showering in addition to help in the home. I rarely leave the house, and cannot do many activities for myself.

After reading and learning more, I decided to talk with my doctor and try again. (This time I was approved!) I think I was approved for a few reasons:

One: Greater Needs

I am worse in some ways than I was before. For example, I really struggle with showering now, to the point that I often can only shower once every 10 days or so.

Also, my ability to cook and meal plan is pretty much non-existent now. Because of this, I live on junk food like chips and snack bars and if I run out of those things, I don’t eat.

Two: Talking to My Doctor

The first time I applied, I didn’t talk with my doctor about the program. I didn’t know the doctor had to fill out forms or that the form had a question asking if I had “nursing home level” or “institutional level” of needs.

I assumed my doctor understood how disabled I was, but that was not the case, and I’m pretty sure she didn’t fill out that part of the form accurately.

The second time I applied, I dedicated an entire doctor’s appointment to telling my doctor I was applying for home aides and talking about my needs. I described all of the things I was struggling with at home and how beneficial it would be for me to have these services.

I did this before reapplying so that when the paperwork arrived for my doctor to fill out, she would already be familiar with my situation and write down the correct information.

Three: Learning The Rules

I tracked down and read through my state’s rules on Medicaid Home Aide eligibility. This allowed me to understand, in much greater detail, what was required to qualify.

From there, I was able to make a list of everything I need help with and then match it to the eligibility criteria. This was really helpful for answering questions during my assessment, because I have such a hard time remembering things and speaking clearly about my needs.

After reading through the information, I felt I should have qualified. Basic criteria: 69147264_2119549135014269_1623244617069625344_o

How Did Things Turn Out?

All in all, I was much more prepared this time. The research and preparation I did were really taxing — mentally, physically, and emotionally — but I think it will be worth it to have the help that I need.

I got approved for the Elderly, Blind, and Disabled Medicaid waiver in Colorado. I was approved for help 9 hours a week and my case manager said I can add more hours if I need to.

I’m so happy to be sharing my story on this blog. It’s such an amazing help to us!! So many people have been able to get the help they deserve! 💜🌷


Dianella’s Year

Dianella made this handy chart of a year-in-the life of someone with chronic illness:

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Thanks for Reading

🌸 This page is part of the free online guide: How to Apply for a State Home Aide Program

🌸 Art on this page by Robin Mead and Elizabeth D’Angelo.

🌸 Page Updated: 10/1/19

🌸 To get daily updates on helpful disability services, and low income programs, follow us on Facebook: The Sleepy Girl Guide.

🌸 Please comment below with stories, ideas, questions or suggestions. Please let us know if any links on this page stop working. Please share this page with others by pressing one of these magic little buttons:

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