• Tel (781) 344-2886
  • Email info@brc-law.com

Law Offices of Barry R. Crimmins

Barry Crimmins

  • Practice Areas
  • Firm Overview
    • News
  • Current Projects
  • Blog
  • Contact Us
    • Stoughton, MA
    • Hyannis, MA
    • Falmouth, MA
Slide background
Legal Expertise, Personally.
Attorney Barry R. Crimmins is someone that you can depend on personally.
We take a small town approach to our client relationships and carry that personal
commitment into all of our cases.
Slide background
Life Happens. We Help You Plan For It.
The many stages of life present a variety of legal implications. Guidance on
Estate Planning and Administration, Medicaid and Elder Law issues are our focus.
Slide background
Real Estate Transactions, Permitting and
Development.
Whether commercial or residential, we have extensive experience in all aspects
of real estate law.

What to Do If Your Medicaid Application Is Denied

April 21, 2022 By Barry Crimmins

If you apply for long-term care assistance through Medicaid and your application is denied, it may feel hopeless. The good news is that you can appeal the decision. 

Medicaid is a program for low-income individuals, so it has strict income and asset eligibility requirements. Qualifying for Medicaid requires navigating the complicated application process, which has many potential stumbling blocks. However, a Medicaid denial does not mean you will not eventually qualify for benefits. 

The Medicaid agency may deny a Medicaid application for a number of reasons, including the following: 

  • Missing documentation. You need to show proof that you are eligible for benefits, which usually means providing Social Security statements, bank records, property deeds, retirement accounts, and insurance records, among other things. 
  • Excess assets. In order to be eligible for Medicaid benefits a nursing home resident may have no more than $2,000 in “countable” assets (in most states). 
  • Transferred assets. If you transferred assets for less than market value within five years before applying for benefits, you may be subject to a penalty period before you become eligible for benefits. 

The Medicaid agency is required to issue the denial notice with 45 days of the application (or 90 days if you filed for benefits on the basis of a disability). When you get a denial notice, read it carefully. The notice will explain why the application was denied and specify how to file an appeal. 

Before filing a formal appeal, you can try informally asking the agency to reverse the decision. If you made a mistake on the application, this is the easiest and quickest way to proceed. If the caseworker made a mistake, it may be more complicated and require escalation to a supervisor or a formal appeal. 

Appealing a Decision
The denial notice will tell how long you have to file an appeal—the deadline may be as short as 30 days or as long as 90 days after the denial notice. It is important to file the appeal before the deadline. Whether the denial notice requires it or not, you should submit your request for an appeal in writing, so that there is a record of it.

Once your appeal is submitted, the Medicaid agency will set a hearing date. Applicants must attend the hearing or their cases will be dismissed. You have a right to have witnesses testify at the hearing and to question the Medicaid agency’s witnesses. It is a good idea to have an attorney to help you through the appeal process. An attorney can make sure you have all the correct documentation and information to present at the hearing. 

If you win the appeal, your benefits will be retroactive to the date of your eligibility—usually the date of your application. If you lose the appeal, the notice will explain how to appeal the decision. The next step in the appeal process usually involves submitting written arguments. If the next appeal is unsuccessful, then you will have to appeal to court. It is crucial to have the assistance of an attorney for this. 

Reapplying for Benefits
If your application was denied correctly due to excess assets or income, there are steps you can take to spend down your assets or put your income in a trust. Contact an attorney to find out what actions you can take to qualify for benefits. Once you do this, you can then reapply for benefits. Note that when you reapply for benefits, your eligibility date will change to the date of the new application. 

Filed Under: blogs

Contact Us Today

  • We are happy to discuss any legal concerns with you.
  • This field is for validation purposes and should be left unchanged.
Communication of information through this website does not create an attorney-client relationship.

Recent Posts

march newsletter

Elder Law News, March 2023

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

BRC Newsletter March

Elder Law News, September 2022

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

august newsletter

Elder Law News, August 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law News - May 2022 Thumbnail

Elder Law News, May 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law NEWS - April 2022

Elder Law News, April 2022

In 2022, change remains constant. But, as it applies to eldercare, some shifts are favorable, while others could directly impact the financial stability and level of care your loved one receives. 

Our expertise includes Real Estate Law and Land Use Permitting, Estate Planning and Estate Administration, with an emphasis on Elder Law and Medicaid Planning.
Practice Areas
We've developed a reputation for excellent service in these areas of the law through more than 35 years of experience.
Our Attorneys
The legal services from the Law Offices of Barry R. Crimmins, P.C. in Stoughton, Falmouth and Hyannis Massachusetts
Our Locations

Recent News

Law Offices of Barry R. Crimmins, PC

march newsletter

Elder Law News, March 2023

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

BRC Newsletter March

Elder Law News, September 2022

As the generation of Baby Boomers ages, many are finding their adult children aren’t in the financial position to provide support if long-term care is needed.

august newsletter

Elder Law News, August 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law News - May 2022 Thumbnail

Elder Law News, May 2022

With healthcare and nursing homes being a hot topic as of late, you may have some questions regarding your care or the care of a loved one. If so…

Elder Law NEWS - April 2022

Elder Law News, April 2022

In 2022, change remains constant. But, as it applies to eldercare, some shifts are favorable, while others could directly impact the financial stability and level of care your loved one receives. 

Links

  • Home
  • News
  • Site map
  • Privacy Policy
  • Terms & Conditions

Contact Us

  • 909 Washington Street, Stoughton, MA 02072
  • 1436 Iyannough Road, Hyannis, MA 02601
  • 20 Academy Lane, Falmouth, MA 02540
  • Phone: (781) 344-2886
  • Email: info@brc-law.com

Follow Us:

  • facebook
  • twitter
  • linkedin

Estate Planning

  • Estate Planning
  • Estate Administration
  • Elder Law
  • Medicaid Planning

Real Estate

  • Land Use Permitting
  • Landlord – Tenant
  • Purchase & Sale Agreements
© Copyright 2023 Law Offices of Barry R. Crimmins, P.C. All rights reserved.
Site Maintained by Interactive Palette