What Do you Do if The Medicaid Application is Denied

medicaid deniedFiling a Medicaid application, especially without the assistance of an attorney, is an arduous task. Five years of account statements from the applicant must be supplied, along with identification information, asset information, and other miscellaneous documentation which may be requested by the Medicaid caseworker. The processing of the application alone can take up to a year, which leaves your family with at least several months of uncertainty.

So what do you do if the Medicaid application is denied?

A denial can be devastating. How will your loved one continue to receive the care that they need? How will the facility get paid for all of that time that the application was pending, and for all the time now accumulating? Will you, the family member, have to use your hard earned savings to pay for your loved one’s care?

In the case of a denial, New Jersey requires that the applicant be afforded the opportunity to appeal the decision by the board of social services and be heard before an administrative law judge in what is called a fair hearing. The applicant is required to receive notice of the fair hearing and to be present at the fair hearing and to present testimony as to why the denial should not have been issued. The applicant is entitled to review their case file with the board of social services before and during the hearing, and is entitled to be represented by legal counsel.

An experienced Bratton Scott elder law attorney can help you navigate the intricate Medicaid rules and help prevent a denial of the application in the first place. However, if you find yourself in a situation where an application was filed privately and a denial was issued, it is best to consult an elder law attorney to help you secure Medicaid benefits for your loved one as quickly as possible. Give us a call today.