Receiving a Medicaid denial notice in Washington can feel like the end of the road, but it doesn’t have to be. There are many reasons why you may receive a long-term care Medicaid denial notice, and depending on the reason, you may have several different appeal options. However, before you try to address a denied Medicaid application, it’s always best that you first get the help of an elder law attorney. So, keep reading to find out why your Medicaid application was denied and whether or not you can appeal this decision.
Common Reasons Medicaid Applications Are Denied
It’s no secret that qualifying for Medicaid can be very challenging due to the sheer amount of eligibility requirements. That is why many Medicaid applications are denied, since applicants may not qualify or made small mistakes with their application.
When you receive a Medicaid denial notice in Washington, your first instinct is probably to try to remedy the situation as soon as possible. However, you first need to understand why Medicaid applications are denied:
- Lack of verification: You must provide the requested paperwork and documentation as a way of verifying that you meet the eligibility criteria for Medicaid. So, if you fail to provide any of this paperwork, your application may be automatically denied.
- Exceeded limits: Medicaid has strict household income and accountable asset limits specifically for Washington residents, which you must meet to qualify. Because of this, you may receive a denial notice if you exceed either the income or countable asset limit, or if there is a paperwork error that makes it seem like you do.
- Administrative errors: The entirety of your Medicaid application needs to be filled out correctly and honestly. If you make any administrative mistakes or provide conflicting information, this could result in a denial.
- Asset transfers: It’s also likely that your application will be denied if you transferred assets under the fair market value during the look-back period. This is why it is so important to have a spend-down strategy before you plan on applying for Medicaid in Washington.
When you begin the Medicaid application process with the help of a Spokane elder law attorney, you can avoid many of these common mistakes. An attorney can help you fill out your application, gather the necessary paperwork, and review your application to check for any errors or inconsistencies.
How to Review Your Denial Notice
When you receive a denial notice regarding your Medicaid application in Washington, you need to thoroughly review the details it provides. Your notice should provide all of the information necessary to help you determine what your next steps should be.
You will need to locate the notice and the action effective date, which provide you with deadlines regarding your next steps. You should then identify the reason for the denial, which should be clearly stated.
When you work with a Medicaid eligibility attorney in Spokane, they can help you determine if it’s possible to address the reason for the denial. Determining whether you can or can’t correct the issue directly will play a big part in what your options are.
For example, you can easily correct an administrative error or missing documentation. Whereas, you may not be able to correct exceeded income or asset limits or asset transfers during the look-back period.
Options After a Medicaid Denial
The good news is that it’s very possible to address a Medicaid denial and have this decision reversed in your favor. Here are some options that you can pursue depending on the reason for the denial and your specific situation:
- Request reconsideration: The most common and effective option to address a denial notice is to initiate a request for reconsideration. You can do this by submitting any missing information or asset authorizations within 30 days of receiving your notice, which automatically triggers a reconsideration to have your case reevaluated.
- Request a hearing: If requesting reconsideration isn’t a good option or doesn’t reverse the denial, the next option you have is to request an administrative hearing. The standard deadline for this is 90 days from the date that you received your notice. Usually, requesting an administrative hearing is only a good option if you have reason to believe the decision was made in error.
- Reapply: You may want to consider reapplying for Medicaid if you have exhausted the above resources but haven’t had any luck. Or, you may wish to simply reapply if the reason for the denial cannot be fixed by requesting reconsideration or a hearing. Keep in mind that reapplying is only a good option if you can directly address the reason for the original denial.
For those already receiving benefits who have received a denial notice after having their case re-reviewed, they have an additional resource they can take advantage of. You can request a service continuation within 10 days of receiving your notice, which allows you to continue to receive your current benefits while you attempt to address the denial.
Get In Touch With an Elder Law Attorney Today
If you need to resolve a denied Medicaid application, you should get the help of an elder law attorney in Spokane, Washington, at Legacy Law Group. Contact us today at 509-315-8087 to speak with one of our attorneys to get the process started.
FAQ
Can I appeal a Medicaid denial in Washington?
Yes. You generally have several appeal options that allow you to have your application reconsidered, especially if you believe the decision was made in error or you can provide missing information.
Can I apply again after being denied?
Washington residents have the right to reapply for Medicaid even if their original application was denied. However, you should only take advantage of this option if you can directly address the reason for the original denial, improving your chances of having your second application approved.
Should I hire an attorney after a denial?
It’s strongly recommended that you get the help of a Medicaid planning attorney in Spokane, Washington, especially if you have received a denial notice. An attorney can help you identify the reason for the denial and determine what your next steps should be.
