Institutional Deeming

Applying for Medicaid Disability for Your Child After 30 Days of Continuous Hospitalization

last updated: Dec 2024

Understanding

Hospital staff (social worker, family support, financial navigator, etc.) should explain Institutional Deeming by day 30 of hospitalization. If no one has talked to you, ask for it. The application process must begin before the child is discharged from the hospital.

Parent income/resources don't count in evaluation of eligibility
This can be secondary to commercial insurance
Coverage can go back to date of birth (if hospitalization started at birth), if approved.
No out-of-pocket expense
Often lasts up to 1 year from approval

Consent

Not all hospitals have staff to help with the application process. If someone is helping, you as the parent or guardian must give signed consent for hospital staff to get started.

Preparation

If you are receiving help to apply, required documentation is collected from you. Expect to sign a few forms to begin the Medicaid application process:

Identity affidavit
Release of medical information form
Authorized representative form consent
Your documents: driver's license, child's birth record/Social Security card, insurance card

Action

If the hospital has someone to help, they should complete the Medicaid application and phone interview with FSSA. They should get the case and ID number during the phone interview. They should follow along and notify you once the eligibility decision is made. (Some hospitals may ask you to handle parts of this process. It is important to know who is doing what.)

Results

If approved, your child will receive Medicaid. You should provide Medicaid information along with primary insurance information when going to any medical provider.

This resource was created in partnership with NICU Nest.

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Programs and systems change often. It is important to ensure that you are using the most current information. Please check https://www.inf2f.org/fact-sheets.html for the most recent edition.

This fact sheet was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $96,750 with 89% percent financed with nongovernmental sources. The contents are those of INF2F and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.