If your claim for Medicaid is denied, you have the right to appeal that decision.

The appeals process is very similar to the Social Security appeals, since they are part of the same legislation. However, each state handles its own appeals process. As part of the denial process, the state in which you live will tell you the procedure for making an appeal.

The purpose of the appeal is the same for each state even if the procedures are different: you want to provide Medicaid with enough new information or explain old information so that they will be justified in reversing their denial and granting you benefits.

In order to successfully change an approval into a denial, you need to know:

• The reason for the denial.
• Your rights of appeal.

Medicaid appeals are in two levels: Reconsideration is first. If you continued to be denied, you can then appeal to an Administrative Law Judge. If not before, it is preferable to have an attorney do the appeal to an Administrative Law Judge.

NOTE: In most states there are programs that will provide information about eligiblity, applying for, appeals, and living with Medicaid. There are even programs which supply people to attend hearings with you. Health insurance assistance program primiarily deal with Medicare, but they also deal with some aspects of Medicaid. You can locate a health insurance assistance program at: see: http://www.familiesusa.org/resources/program-locator/. If the agency doesn't have your answer, it can point you to an agency that does. You can also contact a legal expert to learn about special rules that may help in your situation. If the person charges for his or her services, the more homework you do before meeting, the less expensive your legal feels are likely to be.

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