2024 SERVICE FEES
Massachusetts / Maine / Rhode Island
Our Silver Lining Solutions’ one-time flat fee structure for the full Medicaid application process is as follows:
$3,000 Standard Private Pay Spend Down Rate:
Our services are paid directly by the resident as an allowable Medicaid spend down expense.
$6,000 Complex Private Case Rate:
An application involving a trust, annuity, multiple bank accounts and IRAs (more than three), income property, or spend down of over $70K is billed at this rate to the resident for our services due to the additional time and amount of additional documents that are required for Medicaid approvals.
New Hampshire
*Due to the complexity and additional documentation needed for New Hampshire Medicaid long term care applications and approvals, the following fees are necessary:
$5,000 New Hampshire Standard Private Pay Spend Down Rate:
Our services are paid directly by the resident as an allowable Medicaid spend down expense.
$8,000 New Hampshire Complex Private Case Rate:
An application involving a trust, annuity, multiple bank accounts and IRAs (more than three), income property, or spend down of over $70K is billed at this rate to the resident for our services due to the additional time and amount of additional documents that are required for Medicaid approvals.
ALL NEW ENGLAND STATES
$1,500 Annual Eligibility Review Fee:
Each year after the Medicaid approval, the Client will be required to complete an Eligibility Review application to confirm the Client is still within the asset limits of Medicaid regulations. Silver Lining Solutions will maintain client records up to 2 years upon initial Medicaid approval in order to assist with the Eligibility Review process, for an additional fee. Even if Silver Lining Solutions did not handle the initial Medicaid application, we are still able to assist with the Annual Eligibility Review process.
$1,000 CONSULTATION FEE
Will you need a Long Term Care application within the next year?
Meet with one of our Medicaid Professionals one-on-one to review your assets, understand your spenddown options, and get answers to frequently asked questions. This fee will be applied to your Medicaid application fee when the time comes to prepare and submit a Medicaid long term care application.
$1,500 APPEAL FEES
On occasion, the Medicaid Application benefits are denied for various reasons, and it is necessary to charge an additional $1,500 appeal fee to file a Fair Hearing Request with the Board of Hearings, if substantial work is still needed to continue the case.
Two of the most common denial reasons are missing requested verifications and maintaining account balances over the $2,000 Medicaid asset limit. It is our policy to file a complete Medicaid application initially, including all documents, bank statements, life insurance policies, assets, trusts, etc. This will reduce the number of documents and verifications needed for the 2nd step of the process, the Information Request checklist and to prevent from receiving a Lack of Verification denial notice.
The second common reason for Medicaid denials is being over the Medicaid asset limit at the end of the application process. (*Each state has their own asset limit which must be substantiated during the application process.) For timing purposes, we will file the Medicaid applications when the asset amount is under $20,000, which is approximately one month private pay to the nursing facility. We will guide you through the final stages of the spend down to ensure the assets are under the limit by the final step.
"I should have called Silver Lining Solutions first before trying to submit my own application, which was initially denied. Darcia was able to straighten out my mess and get my mother's benefits approved right away."
- Alan L., Norton, MA
"We made it through the Medicaid maze on the first round. We could not have done it without Silver Lining Solutions’ guidance and assistance."
- Brian S., Danvers, MA