Institutional Deeming

Help a Family Apply for Medicaid Disability for Their Child After 30 Days of Continuous Hospitalization

last updated: Dec 2024

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Explanation

Explain Institutional Deeming to families by day 30 of hospitalization. Institutional Deeming is a way to get Medicaid for children who are hospitalized more than 30 consecutive days if they apply and medically qualify.

• 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

Consent

Obtain consent from the parent/guardian that you apply on their behalf.

Collection

Have the parent/guardian sign the necessary documents for Medicaid application:

• Identity affidavit
• Release of medical information form
• Authorized representative form consent (printed at the end of the application)

Application

• Start the Medicaid application
  
  • https://fssa.benefits.in.gov
    
  • Disabled? Check yes for child
    
  • List all household members; only check "applying" for baby/child
    
  • Address/Phone: use yours if acting as an authorized representative
    
  • Complete full information on family, parent income, and basic job info
    
  • Once submitted, print authorized representative form, save the application, print page 3 cover sheet

Continuation

• Have the doctor sign diagnosis certification
  
• Fax personal documents, medical authorization, diagnosis certification, identity affidavit, authorized representative form, admit note, and relevant/recent progress notes to 800-403-0864, or upload documents to saved application
  
• As the authorized representative, schedule and complete the FSSA phone interview
  
  • Be sure to state that parent income/resources don't count
    
  • Get case & ID number
    
  • Follow to authorization/ approval

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.