The baby boomer generation is aging, and some may find that their parents are in need of nursing home care, or they may have reached an age where they themselves need nursing home care. Many people in such situations will want to apply for Medicaid benefits. However, sometimes when a person applies for Medicaid, their application is denied.
Fortunately, it is possible to appeal such a denial. Medicaid appeals are first filed with the New Jersey Division of Medical Assistance and Health Services. This is the state agency that oversees Medicaid in New Jersey.
Following that, the person will have a hearing with an administrative law judge. Any decisions made at that hearing are recommendations for the final decision. The final decision will then be made by the director of the New Jersey Division of Medical Assistance and Health Services.
If the decision is denied at this point, then a person must submit an appeal to the New Jersey Superior Court. This is not a quick process, as it could take as many as 1.5 years for a person’s case to go before a judge. However, an appeal to a federal court usually only takes around six months.
All of these steps may seem daunting. After all, most laypeople are not experienced in Medicaid appeals. Their main focus is obtaining the benefits they require to afford the care they need. Any missteps along the way could lead to a denied appeal and a further wait time for obtaining benefits. It is at this point that having the assistance of an attorney can be crucial.
At our firm, we work with our clients to develop an effective Medicaid planning strategy. Whether it is a person who has advanced in age or a person who has suffered a catastrophic illness, we understand that Medicaid benefits are the financial lifeline they need to afford nursing home care. When a person is appealing a denied application for Medicaid benefits, it can be a crisis situation. Our webpage on Medicaid Appeals may be a good starting point for those who want more information on this subject.