What to Do if Your Medicaid Application is Denied

When Your Medicaid Application is Denied, get Help From an Elder Law Attorney

Medicaid enables eligible seniors, low-income and disabled people to get the care they need without ruining their families’ financial stability. So, getting a notice that your Medicaid application was denied can have devastating consequences. Some examples of reasons you may be denied Medicaid include incarceration, not meeting residency requirements or too much income/assets.

There are specific time limits for Medicaid appeals. In New York, you must file an appeal within 60 days of receiving a denial notice. If your Medicaid application was denied, you should immediately contact a law firm that specializes in estate and elder law to help you appeal the decision. An experienced elder law attorney in New York can help and advise you how to fast track your appeal (if medically necessary), avoid delays, and avoid additional appeals and denials.

An Attorney can Help You Successfully Appeal a New York State Medicaid Denial

In New York, the Medicaid appeals process is handled by the NY State of Health. It takes about 90 days to have your appeal considered and conduct a hearing. You can also have someone in your family, a friend or lawyer represent you or be witnesses for you on the Fair Hearing phone call. If you have a representative or witness, you need to register them before the hearing date.

Following are the steps in the appeal process:

  • You send in an appeal request, which is actually a request for a Fair Hearing
  • NY State of Health (or another local agency) sends you a notice that they received the request.
  • NY State of Health sets the date for the Fair Hearing.
  • You gather and send in additional information that will mitigate the problem.
  • NY State of Health accepts the information and sets a time for the Fair Hearing phone call
  • A hearing officer calls you and others taking part in the hearing.
  • The hearing officer will record the hearing and usually makes a decision within two to three weeks after the Fair Hearing.
  • If you want to appeal the decision of the Fair Hearing, you can appeal to federal agency here.

An attorney experienced in Medicaid appeals can help you obtain the appropriate documents, forms, representation and witnesses prior to the Fair Hearing phone call.

Contact the Medicaid and Estate Planning Attorneys at Lissner & Lissner LLP

The attorneys at Lissner & Lissner LLP can help you appeal a Medicaid denial. We understand the process and we are familiar with the agencies and courts involved in Medicaid appeals. Located in midtown Manhattan, we have been helping our clients successfully appeal Medicaid denials for more than 65 years. We can help you through the appeals process and represent you in a Fair Hearing. Call (212) 307-1499 or contact us online to schedule a consultation today.

Micheal Lissner
About the Author: Michael Lissner
Micheal D. Lissner is an experienced trust and estate planning and administration attorney serving the New York City area. He handles cases ranging from estate planning to trust administration, medicaid planning, elder law, and representation of survivors of the Holocaust and their heirs