Delaware Medicaid Renewal and Recertification for Long-Term Care

Delaware Medicaid doesn't stay approved forever. Every 12 months, DMMA reviews whether long-term care recipients still qualify, including their financial eligibility and any clinical information the notice requests. Miss this recertification window and your parent's coverage can be terminated, even if nothing about their situation has changed.

When Recertification Happens

DMMA sends a renewal packet before the end of your parent's current eligibility period. The packet arrives by mail and is also available through the ASSIST online portal. The renewal notice gives you 30 days to submit updated documentation.

Mark the date. If the renewal lapses, coverage can stop; follow the notice's instructions to submit missing information or request a review rather than assuming the case will renew automatically.

What Documents You Need

The recertification asks for proof that your parent still meets the $2,000 asset limit and the $2,485 monthly income cap. Gather these before the renewal packet arrives:

• Current bank statements for every account the applicant holds (checking, savings, CDs) — typically the most recent three months
• Updated income documentation — Social Security award letter, pension statements, any IRA or annuity distributions
• Miller Trust records if your parent uses a Qualified Income Trust — provide the most recent trust bank statements showing monthly deposits and disbursements
• Any changes in living situation — if your parent moved between a nursing facility and home care, or if the community spouse's financial situation changed

If your parent's assets have fluctuated — say an inheritance landed or a joint account balance spiked temporarily — document exactly what happened and where the money went. DMMA reviews the information submitted for the renewal.

The Clinical Side

Medical eligibility also gets reviewed. If your parent is already receiving nursing facility care or authorized HCBS through DSHP-Plus, contact the MCO care coordinator about updating the plan of care and ask whether DMMA requires a new PAE Tool-001 or other clinical documentation.

What Happens If You Miss It

If the deadline passes without a completed recertification, DMMA issues a termination notice. Your parent has 60 days from that notice to request a State Fair Hearing to contest the termination. If you want services to continue during the appeal, request continuation by the deadline in the notice; a timely request can keep benefits in place while the appeal is pending — this is called "aid paid pending."

The far better strategy is to never get close to that deadline. Set a calendar reminder 90 days out from the anniversary date and start assembling documents early.

One Common Trap

Families sometimes assume that because their parent's income and assets haven't changed, the renewal is just a formality they can handle later. The problem is that DMMA's system doesn't wait. If documents aren't received by the deadline, the case can close. Even a mailed-but-delayed renewal can arrive after the system has already flagged the case.

Submit through the ASSIST portal whenever possible — it timestamps the submission and gives you a confirmation.

The Delaware Medicaid Long-Term Care & Asset Protection Guide includes an annual redetermination checklist that tracks every document DMMA requires, organized by the timeline that keeps your parent's coverage uninterrupted.

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