May 11, 2023

What is the “Medicaid Pending” problem and how does Sunbound solve it for seniors?

Manny Cominsky

While many people know that Medicaid can help pay for long-term senior care and senior living, many people are less sure about what to do while waiting for Medicaid approval. While some senior living and senior care providers will provide care for seniors who are still waiting to hear back if their Medicaid benefits have been approved, many other senior care providers will not work with seniors who are waiting in limbo, which can cause a great deal of stress to seniors and their loved ones. Fortunately, Sunbound’s new “Medicaid Pending” financing allows seniors who have applied to Medicaid to start receiving care without having to wait for their Medicaid approval.

Sunbound’s Medicaid Financing program allows communities to get coverage for residents who are both “Medicaid Pending” and who have already been approved for Medicaid, but may have some delays in receiving their funds each month. With Sunbound, communities can get funding within 72 hours allowing them to increase their occupancy and improve their financial performance. For seniors and their loved ones, this means that senior residents can move in and start receiving care right away without having to wait for Medicaid approval. To learn more about the “Medicaid Pending” problem and how Sunbound helps solve this problem for seniors, their families, and senior care and senior living providers, read our article below or reach out to the Sunbound team to learn more.

What is the Medicaid Pending problem?

“Medicaid Pending” is the industry term used to describe a senior who has completed their Medicaid application, but is still waiting for their approval and therefore their funds from Medicaid. This period of time, which can sometimes last months, can sometimes be very difficult for seniors who need care right away but cannot afford to pay for their care until they are approved for Medicaid. 

To solve this problem, some senior living communities and nursing homes will allow a senior to move in and start providing them with care as long as the senior has submitted their application for Medicaid. In these cases the senior living community, nursing home, or senior care provider will start providing care for their Medicaid Pending customer or resident, and then get paid retroactively at a later date by Medicaid for the care that they provided. During this time, the senior resident may only be responsible for a portion of their care costs while they are waiting for their Medicaid application to be approved. This can cause operational and financial strain on senior living facilities and senior care operators as they have to front the sometimes quite expensive costs for providing care for their residents until their Medicaid checks come in. 

Unfortunately, even when senior living operators do allow seniors to move in while in Medicaid Pending status, they may only have a limited number of beds that they have set aside for Medicaid and Medicaid pending residents. Therefore, even if you are able to find a senior living community or nursing home that accepts Medicaid pending residents as a general matter, they may not actually be able to offer you or your senior loved one space given their own limitations on how many Medicaid residents they can accept at a given time.

In other cases senior living facilities and senior care operators will either deny coverage to a senior until they have been approved for coverage, or otherwise require a senior or their family to pay for the full cost of care until the senior’s Medicaid application has been approved. This can cause financial strain for seniors and their loved ones as they pay for senior care in the short term, and can cause even more financial pressure as they will often not be reimbursed for this cost as Medicaid will often pay the senior living operator directly once the senior’s Medicaid application has been approved.

How long does Medicaid approval take?

Generally, a Medicaid application will be processed in 45 to 90 days, although this process can take shorter or longer depending on both the state Medicaid’s agency’s own requirements as well as the particular circumstances of each individual case. One thing to keep in mind is that while federal law mandates a 45-90 day application process, this does not count the often time consuming work of putting together both an application and all the required documentation that goes with it. This process can be further delayed if an application is submitted improperly or without the required documentation, forcing the senior or their family to re-apply or spend time collecting the right documentation. When all is said and done, the full Medicaid application and approval process can sometimes take several months for seniors. 

For those whose Medicaid applications are denied there is the option to appeal the denial of Medicaid care, however this will of course increase the timeline for receiving Medicaid funds. Because this appeal process will involve an appeal hearing in front of an administrative law judge, it will often make sense for the senior and their family to get an elder law attorney to help them through the process (which of course adds to the financial burden for the senior or their family). For this reason, it’s particularly important for seniors and their loved ones to figure out their Medicaid approval on the front end without having to resort to a sometimes lengthy appeal process on the backend.

How does Sunbound solve the Medicaid Pending Problem?

For all of these reasons, Sunbound has created the first tech-enabled, easy to use Medicaid Pending solution for seniors, their families, and senior living operators. Sunbound provides no-interest, flexible financing as well as Medicaid application support to allow seniors to start receiving care as soon as they need it, and for senior living operators to receive funds as soon as they provide care. Whether you’re a senior living resident or a senior living operator, Sunbound can help you solve your Medicaid Pending problem today. 

To learn more about how Sunbound can help make senior living more affordable for you or your loved one, send us an email at or request more information on Sunbound. Sunbound is the best way to pay for senior living and is on a mission to make senior living affordable for everyone.

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