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Legal Q&A: Appealing Medicaid Denials

Question: DHMH has denied my mother's request to receive long term care Medicaid benefits. Is there any way we can appeal this decision, and how would we go about doing this?

Answer: You have the right to appeal the decision denying your mother's Medicaid. It is extremely important that you act immediately, because you generally have a very limited time in which to file your appeal. In Maryland, the Decision form which the State sends out has the specific instructions regarding the steps necessary to appeal the denial of benefits.

It is strongly recommend that you immediately hire an experienced Elder Law Attorney to represent your mother. First, the Attorney can evaluate the decision to see why benefits were denied. Frequently, when someone files an Application themselves or with the assistance of someone other than an Attorney, the application is completed incorrectly or insufficient information is provided to the State. In Maryland, the State will deny an application because it is incorrectly completed, does not contain the required back up documentation or you fail to provide the additional documentation the State requests within the time they give you, usually 10 days. These denials occur even though the applicant is entitled to Medicaid and would receive it if the application was done correctly.

Obviously, denial may also be because your mother does not qualify for Medicaid or because she has made improper transfers of assets which cause her disqualification.

An Elder Law Attorney can advise you whether the reason for the denial is appealable or whether there are additional steps necessary to protect your mother's interests.

If you have additional questions, you may want to talk with an attorney at Michael Hodes, LLC (410) 769-8002 about this matter.

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Above content provided by Michael Hodes, LLC. For advice about legal issues, consult a licensed Attorney.

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