Medicaid can be a great way to secure reliable health care for you and your family. To qualify, however, you must meet strict guidelines regarding income and asset limits, which change from year to year. If your Medicaid application has been denied, the attorneys at Pierro, Connor & Strauss can provide experienced and effective counsel through the Medicaid appeals process and help you or your loved one develop a plan to qualify for benefits.

Remember, if your application for Medicaid in New York is denied, you have the right to file an appeal. It is not uncommon for those who should rightfully qualify to be denied coverage. At Pierro, Connor & Strauss, we help individuals in the greater Albany area and throughout New York understand Medicaid eligibility and what they need to do to secure Medicaid coverage.

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Reasons for New York Medicaid appeals

In New York, Medicaid is available to state residents who are:

  • U.S citizens or in the country legally;

  • Need health care or insurance assistance; or

  • Qualify as low or very low income; and are one of the following:

      • Pregnant,
      • Responsible for a minor child,
      • Blind,
      • At least 65 years old, or
      • Personally have, or have a family member in the same household with, a disability.

A Medicaid application could be denied for a number of reasons. It may simply be missing information or necessary attachments, it could include incorrect information, or it may be unclear why the applicant falls within the above qualifications. It is also possible that the government reviewer did not understand the information previously submitted.

When an application is denied, the applicant has the right to represent himself or herself in an appeal. However, that is not always the wisest way to proceed. Without a thorough understanding of how the Medicaid system operates, filing an appeal can be challenging. An experienced attorney can greatly increase the likelihood of success.

How a New York Medicaid appeals lawyer can help

If you appeal a Medicaid denial, you are entitled to a Fair Hearing. This may not sound very formal, but in reality, it is an adversarial process. The hearing takes place before an administrative law judge. A Medicaid representative likely will appear to argue that your denial was proper. However, you have the right to present a case for coverage. If the appeal isn’t successful, the applicant must apply again and will lose both valuable time as well as any chance of reimbursement for the time the application and appeal were pending.

Avoid Medicaid appeals by planning ahead

People from all walks of life may be eligible for Medicaid assistance, but certain individuals are most likely to benefit from the assistance of a Medicaid planning lawyer. For example:

  • Aging adults and others who may need long-term care may face considerable costs. Long-term care planning can help eliminate or at least lessen those costs by ensuring Medicaid eligibility is available when needed.
  • Families of those with special needs encounter challenges with preserving assets while maintaining their loved ones’ eligibility for government benefits. Estate planning tools including different types of trusts can help meet these goals.

There is no one-size-fits-all solution, and the options are state-specific. It is therefore important to discuss your situation with an experienced New York lawyer.

Schedule a consultation with a knowledgeable NY Medicaid appeals lawyer

At Pierro, Connor, & Strauss, our attorneys can help you traverse the Medicaid process. Our seasoned professionals stay abreast of the statutory changes that can affect your eligibility and we are not afraid to fight an unfair denial.

If you are just getting started on the Medicaid process or you think you or someone you love may need Medicaid in the future, we can also help you with planning and the application process. If you are in Schenectady, Saratoga, or elsewhere in the Albany area, call today to schedule a free consultation with our Medicaid attorneys.

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Contact us today for a FREE consultation and we’ll be happy to help take the worry out of tomorrow so you can live today.

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