Can I Appeal An Adverse Medicaid Eligibility Decision?

If Medicaid makes a determination that adversely affects your benefits you must be given written notice detailing the reason(s) for Medicaid’s decision and be notified of your right to request a “fair hearing”. You have a right to a “fair hearing” – the method to appeal a decision made regarding your Medicaid benefits – when Medicaid takes the following action:

1. Determines that you are not eligible for Medicaid benefits.
2. Makes the decision to stop, suspend, or reduce Medicaid benefits that you have previously been receiving.
3. Fails to make a decision regarding your Medicaid eligibility within a reasonable time period.

At the fair hearing you are given access to your Medicaid case file and have a right to be represented by counsel. Regulations concerning Medicaid eligibility are difficult to understand. For this reason it can be extremely valuable to consult with an experienced elder law attorney to make sure you receive the Medicaid benefits you are entitled to. The Law Office of David K. Whitlock has the experience necessary to represent your interests at a Fair Hearing.